Rojano-Toimil Alba, Rivera-Esteban Jesús, Manzano-Nuñez Ramiro, Bañares Juan, Martinez Selva David, Gabriel-Medina Pablo, Ferrer Roser, Pericàs Juan M, Ciudin Andreea
Endocrinology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain.
Vall d'Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain.
J Clin Med. 2022 Jun 8;11(12):3286. doi: 10.3390/jcm11123286.
Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) have been traditionally linked to one another. Recent studies suggest that NAFLD may be increasingly common in other types of diabetes such as type 1 diabetes (T1DM) and less frequently ketone-prone and Maturity-onset Diabetes of the Young (MODY) diabetes. In this review, we address the relationship between hyperglycemia and insulin resistance and the onset and progression of NAFLD. In addition, despite the high rate of patients with T2DM and other diabetes phenotypes that can alter liver metabolism and consequently develop steatosis, fibrosis, and cirrhosis, NALFD screening is not still implemented in the daily care routine. Incorporating a clinical algorithm created around a simple, non-invasive, cost-effective model would identify high-risk patients. The principle behind managing these patients is to improve insulin resistance and hyperglycemia states with lifestyle changes, weight loss, and new drug therapies.
2型糖尿病（T2DM）和非酒精性脂肪性肝病（NAFLD）传统上一直相互关联。最近的研究表明，NAFLD在其他类型的糖尿病中可能越来越常见，如1型糖尿病（T1DM），而在酮症倾向型和青少年成年发病型糖尿病（MODY）中则较少见。在本综述中，我们探讨了高血糖与胰岛素抵抗之间的关系以及NAFLD的发生和发展。此外，尽管T2DM和其他可改变肝脏代谢并进而发展为脂肪变性、纤维化和肝硬化的糖尿病表型患者比例很高，但NAFLD筛查仍未纳入日常护理常规。采用围绕简单、非侵入性、成本效益高的模型创建的临床算法将识别出高危患者。管理这些患者的原则是通过生活方式改变、体重减轻和新的药物治疗来改善胰岛素抵抗和高血糖状态。
