Koullias Emmanouil S, Koskinas John
2nd Department of Internal Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece.
J Clin Transl Hepatol. 2022 Oct 28;10(5):965-971. doi: 10.14218/JCTH.2021.00564. Epub 2022 May 30.
Non-alcoholic fatty liver disease (NAFLD) and diabetes mellitus type 2 commonly coexist as a manifestation of metabolic syndrome. The presence of diabetes promotes the progression of simple fatty liver to non-alcoholic steatohepatitis (NASH) and cirrhosis, and the presence of NAFLD increases the risk of diabetic complications. This coexistence affects a large part of the population, imposing a great burden on health care systems worldwide. Apart from diet modification and exercise, recent advances in the pharmacotherapy of diabetes offer new prospects regarding liver steatosis and steatohepatitis improvement, enriching the existing algorithm and supporting a multifaceted approach to diabetic patients with fatty liver disease. These agents mainly include members of the families of glucagon-like peptide-1 analogues and the sodium-glucose co-transporter-2 inhibitors. In addition, agents acting on more than one receptor simultaneously are presently under study, in an attempt to further enhance our available options.
非酒精性脂肪性肝病(NAFLD)与2型糖尿病常作为代谢综合征的一种表现同时存在。糖尿病的存在会促使单纯性脂肪肝进展为非酒精性脂肪性肝炎(NASH)和肝硬化,而NAFLD的存在会增加糖尿病并发症的风险。这种共存影响了很大一部分人群,给全球医疗保健系统带来了巨大负担。除了饮食调整和运动外,糖尿病药物治疗的最新进展为改善肝脂肪变性和脂肪性肝炎提供了新的前景,丰富了现有的治疗方案,并支持对脂肪肝疾病糖尿病患者采取多方面的治疗方法。这些药物主要包括胰高血糖素样肽-1类似物家族成员和钠-葡萄糖协同转运蛋白-2抑制剂。此外,目前正在研究同时作用于多个受体的药物,以进一步增加我们可用的治疗选择。