脂质代谢紊乱与药物性肝损伤的关联机制及研究现况OA

Drug-induced liver injury(DILI)is a common and highly heterogeneous adverse drug reaction in clinical practice.Drug-induced fatty liver disease(DIFLD)is a distinct subtype of DILI characterized primarily by abnormal hepatic lipid accumulation.Meanwhile,pre-existing metabolic dysfunction-associated steatotic liver disease(MASLD)may serve as a susceptible background that increases the risk of DILI and influences clinical outcomes.Accordingly,DIFLD and DILI occurring in the setting of MASLD are related,while differing in their pathologic basis and clinical features.Current research suggests that the development and progression of both reactions involve multiple mechanisms,including mitochondrial dysfunction,dysregulation of nuclear receptors and transcriptional control,imbalance between lipid synthesis and export,oxidative stress,and activation of inflammatory pathways.This article reviews the epidemiologic characteristics,interaction mechanisms,and clinical outcomes associated with lipid metabolism disorders and DILI,with the aim of providing a basis for identification of high-risk populations,individualized drug therapy,and safety evaluation of new drugs.