Brůha R, Dvořák K, Petrtýl J
IV. interní klinika 1. lékařské fakulty UK a VFVN Praha.
Vnitr Lek. 2013 Jul;59(7):546-50.
There is a mutual relationship between diabetes and liver disorders. Diabetic patients suffer from liver disorders more frequently and, vice versa, patients with liver disorders are at a higher risk of developing diabetes. Diabetes is probably the most common cause of chronic liver disorders in developed countries. Liver disorders related to diabetes include a wide spectrum of conditions, from a simple steatosis related to a slight elevation of liver tests through nonalcoholic steatohepatitis with various degrees of fibrosis up to cirrhosis, hepatocellular carcinoma and acute liver failure. Non alcoholic liver steatosis is the most common pathological condition that is, at present, considered to be a component of or to actually be the liver manifestation of metabolic syndrome, accompanied with an insulin resistance and other clinical components, such as central obesity, dyslipidemia, arterial hypertension and the already mentioned type 2 diabetes mellitus. The steatosis itself is a benign condition and the unfavourable development of the liver disorder is related to an inflammatory reaction (steatohepatitis) and subsequent fibrosis. There is no specific treatment for nonalcoholic steatohepatitis. The basic measures include weight reduction, lifestyle changes and treatment of the concurrent conditions, such as diabetes and dyslipidemia. Formerly popular "hepatoprotective" substances do not play an important role in the treatment of steatohepatitis.
糖尿病与肝脏疾病之间存在相互关系。糖尿病患者更常患肝脏疾病，反之，肝脏疾病患者患糖尿病的风险更高。在发达国家，糖尿病可能是慢性肝脏疾病最常见的病因。与糖尿病相关的肝脏疾病包括广泛的病症，从与肝功能检查轻度升高相关的单纯脂肪变性，到伴有不同程度纤维化的非酒精性脂肪性肝炎，直至肝硬化、肝细胞癌和急性肝衰竭。非酒精性肝脂肪变性是目前最常见的病理状况，被认为是代谢综合征的一个组成部分或实际上是其肝脏表现，伴有胰岛素抵抗和其他临床特征，如中心性肥胖、血脂异常、动脉高血压以及上述的2型糖尿病。脂肪变性本身是一种良性状况，肝脏疾病的不良发展与炎症反应（脂肪性肝炎）及随后的纤维化有关。非酒精性脂肪性肝炎没有特效治疗方法。基本措施包括减轻体重、改变生活方式以及治疗并存疾病，如糖尿病和血脂异常。以前常用的“保肝”物质在脂肪性肝炎的治疗中并不起重要作用。
