Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania.
St. Spiridon Emergency Hospital, Iasi 700115, Romania.
Can J Gastroenterol Hepatol. 2020 Dec 28;2020:6638306. doi: 10.1155/2020/6638306. eCollection 2020.
Worldwide, the leading cause of chronic liver disease is represented by nonalcoholic fatty liver disease (NAFLD) which has now become a global epidemic of the 21st century, affecting 1 in 4 adults, and which appears to be associated with the steadily increasing rates of metabolic syndrome and its components (obesity, type 2 diabetes mellitus (T2DM), and dyslipidemia). NAFLD has been reported to be associated with extrahepatic manifestations such as cardiovascular disease, T2DM, chronic kidney disease, extrahepatic malignancies (e.g., colorectal cancer), endocrine diseases (e.g., hypothyroidism, polycystic ovarian syndrome, psoriasis, and osteoporosis), obstructive sleep apnea, and iron overload. The prevalence of NAFLD is very high, affecting 25-30% of the world population and encloses two steps: (1) nonalcoholic fatty liver (NAFL), which includes steatosis only, and (2) nonalcoholic steatohepatitis (NASH) defined by the presence of steatosis and inflammation with hepatocyte ballooning, with or without fibrosis which can progress to liver fibrosis, hepatocellular carcinoma, and liver transplantation. Current data define a more complex relationship between NAFLD and T2DM than was previously believed, underlining a bidirectional and mutual association between the two entities. This review aims to summarize the current literature regarding the incidence of T2DM among patients with NAFLD and also the prevalence of NAFLD in T2DM patients, highlighting the recent key studies. Clinicians should screen, diagnose, and treat T2DM in patients with NAFLD in order to avoid short- and long-term complications.
在全球范围内，非酒精性脂肪性肝病（NAFLD）是导致慢性肝病的主要原因，它已成为 21 世纪的全球性流行疾病，影响到四分之一的成年人，且似乎与代谢综合征及其成分（肥胖、2 型糖尿病（T2DM）和血脂异常）的发病率稳步上升有关。NAFLD 与多种肝外表现相关，如心血管疾病、T2DM、慢性肾脏病、肝外恶性肿瘤（如结直肠癌）、内分泌疾病（如甲状腺功能减退症、多囊卵巢综合征、银屑病和骨质疏松症）、阻塞性睡眠呼吸暂停和铁过载。NAFLD 的患病率非常高，影响了全球 25-30%的人口，包含两个阶段：（1）非酒精性单纯性脂肪肝（NAFL），仅包括脂肪变性；（2）非酒精性脂肪性肝炎（NASH），定义为脂肪变性和炎症伴肝细胞气球样变，伴有或不伴有纤维化，可进展为肝纤维化、肝细胞癌和肝移植。目前的数据定义了 NAFLD 和 T2DM 之间比以前认为的更为复杂的关系，强调了这两种实体之间的双向和相互关联。本综述旨在总结关于 NAFLD 患者中 T2DM 发病率的现有文献，以及 T2DM 患者中 NAFLD 的患病率，突出最近的关键研究。临床医生应该对 NAFLD 患者进行 T2DM 的筛查、诊断和治疗，以避免短期和长期并发症。
