Diaconu Cosmina-Theodora, Guja Cristian
Department of Diabetes, Nutrition and Metabolic Diseases, "Prof. Dr. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 030167 Bucharest, Romania.
Doctoral School of "Carol Davila" University of Medicine and Pharmacy, Dionisie Lupu 37, 020021 Bucharest, Romania.
J Clin Med. 2022 Aug 31;11(17):5144. doi: 10.3390/jcm11175144.
Prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) and Type 2 Diabetes Mellitus (T2DM) are increasing rapidly worldwide, reaching epidemic proportions. Their association, based on common metabolic risk factors (obesity, insulin resistance (IR), unhealthy lifestyle), brings an additional risk of both hepatic and cardiovascular (CV) adverse clinical outcomes. The terminology of "NAFLD" is stigmatizing to some but not all patients, and a more practical one should be announced soon. Medical strategies can address both diseases simultaneously, as they have crossing pathophysiological mechanisms, mainly IR. Strategies vary from lifestyle intervention and pharmacological options, as more molecules designated for T2DM treatment may be helpful in NAFLD, to surgical procedures. This review focuses on the coexistence of NAFLD and T2DM, pointing out the utility of the appropriate terminology, its prevalence, and mortality rates among the diabetic population. Briefly, we have discussed the main pathophysiological mechanisms and the risk stratification algorithm for the development of NAFLD and nonalcoholic steatohepatitis (NASH) as well as the tools for evaluation of fibrosis. Finally, we have focused on the current therapeutic options for the treatment of NAFLD associated with T2DM.
非酒精性脂肪性肝病（NAFLD）和2型糖尿病（T2DM）在全球范围内的患病率正在迅速上升，已达到流行程度。基于共同的代谢危险因素（肥胖、胰岛素抵抗（IR）、不健康的生活方式），它们之间的关联带来了肝脏和心血管（CV）不良临床结局的额外风险。“NAFLD”这一术语对部分但并非所有患者来说都带有污名化色彩，应该很快会公布一个更实用的术语。医学策略可以同时应对这两种疾病，因为它们有交叉的病理生理机制，主要是IR。策略从生活方式干预和药物选择（由于更多用于T2DM治疗的分子可能对NAFLD有帮助）到手术程序不等。本综述重点关注NAFLD和T2DM的共存情况，指出合适术语的实用性、其患病率以及糖尿病患者中的死亡率。简要地说，我们讨论了NAFLD和非酒精性脂肪性肝炎（NASH）发生发展的主要病理生理机制和风险分层算法以及纤维化评估工具。最后，我们重点关注了当前治疗与T2DM相关的NAFLD的治疗选择。
