文章摘要
杨明,周雁.老年瘦型代谢相关脂肪性肝病的临床特点与综合管理[J].中国临床保健杂志,2026,29(3):305-309.
老年瘦型代谢相关脂肪性肝病的临床特点与综合管理
Clinical characteristics and comprehensive management of lean metabolic dysfunction-associated fatty liver disease in older adults
投稿时间：2026-05-17  
DOI：10.3969/J.issn.1672-6790.2026.03.003
中文关键词: 瘦型代谢相关脂肪性肝病  肥胖,腹部  肌少症  健康老龄化  老年人
英文关键词: Lean metabolic dysfunction-associated fatty liver disease  Obesity,abdominal  Sarcopenia  Healthy aging  Aged Fund program:National High Level Hospital Clinical Research Funding
基金项目:中央高水平医院临床科研业务费专项
作者单位
杨明 北京医院国家老年医学中心全科医学科特需医疗部健康管理中心,老年疾病国家临床医学研究中心,国家卫生健康委老年医学重点实验室,中国医学科学院老年医学研究院,北京 100730 
周雁 北京医院国家老年医学中心全科医学科特需医疗部健康管理中心,老年疾病国家临床医学研究中心,国家卫生健康委老年医学重点实验室,中国医学科学院老年医学研究院,北京 100730 
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中文摘要:
      老年瘦型代谢相关脂肪性肝病(MAFLD)是MAFLD的特殊亚型,占老年MAFLD患者的10%~20%,其特点为体重指数正常但存在内脏脂肪堆积和代谢紊乱。老年瘦型MAFLD尽管代谢异常程度轻于肥胖型MAFLD,但其肝纤维化进展更快,全因死亡风险更高。其发病涉及遗传、代谢、肠道菌群等多因素相互作用,早期筛查和精准评估对疾病管理至关重要。综合管理策略包括生活方式干预、药物治疗和并发症防治等多学科协作模式。未来研究应聚焦于发病机制、生物标志物开发和个体化治疗方案的优化。本文阐述了老年瘦型MAFLD的流行病学与临床特点、危险因素及发病机制、筛查评估和综合管理策略。
英文摘要:
      Lean metabolic dysfunction-associated fatty liver disease (MAFLD) in older adults is a distinct subtype of MAFLD,accounting for approximately 10%-20% of MAFLD in the elderly cases.It is characterized by a normal body mass index but with visceral fat accumulation and metabolic disturbances.Although the degree of metabolic abnormality is milder than in obese MAFLD,lean MAFLD in older adults shows faster progression of liver fibrosis and a higher risk of all-cause mortality.Its pathogenesis involves the interplay of genetic,metabolic,and gut microbiota-related factors.Early screening and precise assessment are crucial for disease management.Comprehensive management strategies include lifestyle interventions,pharmacological treatments,and multidisciplinary approaches to prevent and manage complications.Future research should focus on elucidating pathogenic mechanisms,developing biomarkers,and optimizing individualized therapeutic strategies.This review summarizes the epidemiology and clinical characteristics,risk factors and pathogenesis,screening and assessment methods,as well as comprehensive management strategies for lean MAFLD in older adults.
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