a switch in hepatic cortisol metabolism across the spectrum of non alcoholic fatty liver disease开关在肝皮质醇代谢谱的非酒精性脂肪肝.pdfVIP

A Switch in Hepatic Cortisol Metabolism across the Spectrum of Non Alcoholic Fatty Liver Disease 1 1 2 2 4 1 Adeeba Ahmed , Elizabeth Rabbitt , Theresa Brady , Claire Brown , Peter Guest , Iwona J. Bujalska , 1 3 5 3 3 Craig Doig , Philip N. Newsome , Stefan Hubscher , Elwyn Elias , David H. Adams , Jeremy W. 1 1 Tomlinson , Paul M. Stewart * 1 Centre for Endocrinology, Diabetes and Metabolism, Institute of Biomedical Research, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, United Kingdom, 2 Wellcome Trust Clinical Research Facility, University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom, 3 Centre for Liver Research and NIHR Biomedical Research Unit in Liver Disease, University Hospital Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, United Kingdom, 4 Radiology, University Hospital Birmingham NHS Foundation, Trust, Birmingham, United Kingdom, 5 Pathology, University Hospital Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, United Kingdom Abstract Context: Non alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. NAFLD represents a spectrum of liver disease ranging from reversible hepatic steatosis, to non alcoholic steato-hepatitis (NASH) and cirrhosis. The potential role of glucocorticoids (GC) in the pathogenesis of NAFLD is highlighted in patients with GC excess, Cushing’s syndrome, who develop central adiposity, insulin resistance and in 20% of cases, NAFLD. Although in most cases of NAF