Intestinal permeability in human nonalcoholic fatty liver disease: A systematic review and meta-analysis.
Intestinal permeability in human nonalcoholic fatty liver disease: A systematic review and meta-analysis.
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人类非酒精性脂肪性肝病的肠道通透性：一项系统回顾和荟萃分析。
DOI：
10.1111/liv.14696
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Koek GH
中科院分区：
文献类型：
--
作者：
De Munck TJI;Xu P;Verwijs HJA;Masclee AAM;Jonkers D;Verbeek J;Koek GH
肠肝轴被认为在非酒精性脂肪性肝病（NAFLD）的发生和进展中发挥着关键作用。上皮屏障的完整性对于保护肝脏免受肠道微生物产物的入侵至关重要，尽管其在 NAFLD 发病和进展中的确切作用尚不清楚。我们对研究肠道通透性 (IP) 与 NAFLD 存在或严重程度（定义为非酒精性脂肪性肝炎 (NASH) 的存在以及脂肪变性、肝脏炎症或纤维化的程度）之间的关系进行了系统回顾和荟萃分析。共有 14 项研究符合纳入条件。调查成人 (n = 6) 和儿童 (n = 8) NAFLD 中 IP 的研究显示了类似的结果。其中 13 项研究重点关注小 IP，两项研究关注全肠道通透性，没有一项研究关注结肠通透性。在汇总分析中，根据双糖测试（标准化平均差 0.79，95% CI 0.49‐1.08）和血清连蛋白水平（标准化平均差 1.04 ng/mL，95% CI 0.40‐1.68），NAFLD 患者显示出小肠通透性增加。单纯性脂肪变性和 NASH 患者之间没有观察到 IP 的明显差异。此外，在 4/4 的研究中，全肠道和小肠通透性随着肝脏脂肪变性程度的增加而增加，但没有观察到与肝脏炎症或纤维化的相关性。根据现有的有限研究，与健康对照相比，NAFLD 患者的 IP 似乎有所增加，并且与肝脂肪变性的程度相关。
The gut‐liver axis is considered to play a critical role in the development and progression of nonalcoholic fatty liver disease (NAFLD). The integrity of the epithelial barrier is crucial to protect the liver against the invasion of microbial products from the gut, although its exact role in NAFLD onset and progression is not clear. We performed a systematic review and meta‐analysis of studies that addressed the intestinal permeability (IP) in association with NAFLD presence or severity as defined by the presence of nonalcoholic steatohepatitis (NASH) and the degree of steatosis, hepatic inflammation or fibrosis. A total of 14 studies were eligible for inclusion. Studies investigating IP in adult (n = 6) and paediatric (n = 8) NAFLD showed similar results. Thirteen of the included studies focussed on small IP, two studies on whole gut permeability and none on colonic permeability. In the pooled analysis, NAFLD patients showed an increased small intestinal permeability compared to healthy controls based on dual sugar tests (standardized mean difference 0.79, 95% CI 0.49‐1.08) and serum zonulin levels (standardized mean difference 1.04 ng/mL, 95% CI 0.40‐1.68). No clear difference in IP was observed between simple steatosis and NASH patients. Furthermore, whole gut and small intestinal permeability increased with the degree of hepatic steatosis in 4/4 studies, while no association with hepatic inflammation or fibrosis was observed. Based on the limited number of studies available, IP appears to be increased in NAFLD patients compared to healthy controls and is associated with the degree of hepatic steatosis.
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影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
1.2
作者：
Cakir, Murat;Isbilen, Ayse Aksel;Kaya, Gulay
通讯作者：
Kaya, Gulay
影响因子：
24.5
作者：
Camilleri, Michael
通讯作者：
Camilleri, Michael
影响因子：
6.6
作者：
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通讯作者：
Nobili, Valerio
DOI：
10.1152/ajpgi.00330.2013
发表时间：
2014-01-01
影响因子：
4.5
作者：
Pijls, Kirsten E.;Koek, Ger H.;Jonkers, Daisy M. A. E.
通讯作者：
Jonkers, Daisy M. A. E.