非酒精性脂肪性肝病与2型糖尿病的共存
The Coexistence of Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus.
作者信息
Kosmalski Marcin, Ziółkowska Sylwia, Czarny Piotr, Szemraj Janusz, Pietras Tadeusz
机构信息
Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland.
Department of Medical Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland.
出版信息
J Clin Med. 2022 Mar 2;11(5):1375. doi: 10.3390/jcm11051375.
The incidence of nonalcoholic fatty liver disease (NAFLD) is growing worldwide. Epidemiological data suggest a strong relationship between NAFLD and T2DM. This is associated with common risk factors and pathogenesis, where obesity, insulin resistance and dyslipidemia play pivotal roles. Expanding knowledge on the coexistence of NAFLD and T2DM could not only protect against liver damage and glucotoxicity, but may also theoretically prevent the subsequent occurrence of other diseases, such as cancer and cardiovascular disorders, as well as influence morbidity and mortality rates. In everyday clinical practice, underestimation of this problem is still observed. NAFLD is not looked for in T2DM patients; on the contrary, diagnosis for glucose metabolism disturbances is usually not performed in patients with NAFLD. However, simple and cost-effective methods of detection of fatty liver in T2DM patients are still needed, especially in outpatient settings. The treatment of NAFLD, especially where it coexists with T2DM, consists mainly of lifestyle modification. It is also suggested that some drugs, including hypoglycemic agents, may be used to treat NAFLD. Therefore, the aim of this review is to detail current knowledge of NAFLD and T2DM comorbidity, its prevalence, common pathogenesis, diagnostic procedures, complications and treatment, with special attention to outpatient clinics.
非酒精性脂肪性肝病(NAFLD)在全球范围内的发病率正在上升。流行病学数据表明,NAFLD与2型糖尿病(T2DM)之间存在密切关系。这与常见的风险因素和发病机制相关,其中肥胖、胰岛素抵抗和血脂异常起着关键作用。深入了解NAFLD和T2DM的共存情况,不仅可以预防肝损伤和糖毒性,从理论上讲,还可能预防随后发生的其他疾病,如癌症和心血管疾病,并影响发病率和死亡率。在日常临床实践中,这个问题仍然被低估。在T2DM患者中未对NAFLD进行筛查;相反,NAFLD患者通常也未进行糖代谢紊乱的诊断。然而,仍然需要简单且经济有效的方法来检测T2DM患者的脂肪肝,尤其是在门诊环境中。NAFLD的治疗,特别是与T2DM共存时,主要包括生活方式的改变。也有人建议,包括降糖药在内的一些药物可用于治疗NAFLD。因此,本综述的目的是详细阐述NAFLD和T2DM合并症的现有知识,包括其患病率、常见发病机制、诊断程序、并发症和治疗,特别关注门诊诊所。