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摘要：
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摘要：随着饮食和生活方式的变化，代谢相关脂肪性肝病（metabolic associated fatty
liver disease，MAFLD）目前已成为全球最常见的慢性肝病之一，肥胖被认为是其主要
的诱发因素之一。MAFLD病理机制复杂，涉及胰岛素抵抗、脂肪代谢紊乱、慢性低度
炎症等多个方面。近年研究表明，减重管理在改善MAFLD疗效方面发挥重要作用。生
活方式干预（包括饮食、运动）、药物治疗及手术治疗后的减重管理能够有效改善肝
脏脂肪变、减缓肝纤维化进展。本文将探讨肥胖对MAFLD的病理机制、临床预后、减
重治疗的机制与临床实践进展，同时展望未来的干预策略，包括肠道菌群调节、新靶
点药物研发及精准医学在MAFLD中的应用。
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Abstract: With changes in diet and lifestyle, metabolic associated fatty liver disease (MAFLD)
has become one of the most common chronic liver diseases globally, and obesity is considered
to be a major contributing factor. The pathogenesis of MAFLD is complex, involving insulin
resistance, lipid metabolism disorders and chronic low-grade inflammation. Recent studies had
demonstrated that weight management played a crucial role in improving MAFLD outcomes.
Interventions such as lifestyle modifications (including diet and exercise), pharmacological
treatments and bariatric surgery had shown efficacy in reducing hepatic steatosis and slowing
fibrosis progression. This review explored the pathophysiological mechanisms linking obesity
and MAFLD, clinical prognosis, the mechanisms and clinical advances in weight management
therapies and future intervention strategies, including gut microbiota modulation, development
of novel therapeutic targets, and the application of precision medicine in MAFLD.
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