Emory University School of Medicine, 775 Johnson Ferry Rad. NE, Atlanta, GA 30342, USA; Atlanta, GA, USA.
Endocrinol Metab Clin North Am. 2023 Mar;52(1):149-164. doi: 10.1016/j.ecl.2022.06.007. Epub 2022 Nov 18.
Management of nonalcoholic fatty liver disease (NAFLD) is crucial for type 2 diabetes (T2D) remission because they are linked through the common pathophysiology of insulin resistance and lipotoxicity. One in three patients with T2D has nonalcoholic steatohepatitis leading to fibrosis, cirrhosis, and hepatocellular carcinoma. Noninvasive testing with imaging and/or serum biomarkers can assess the risk for advanced liver disease. A liver biopsy is only necessary in select patients where there is diagnostic doubt. Treatments for NAFLD parallel T2D remission strategies focusing on weight loss and managing comorbid conditions through lifestyle modification, antiobesity medications, and/or bariatric surgery, and T2D medications with proven efficacy.
非酒精性脂肪性肝病（NAFLD）的管理对于 2 型糖尿病（T2D）的缓解至关重要，因为它们通过胰岛素抵抗和脂毒性的共同病理生理学联系在一起。三分之一的 T2D 患者患有非酒精性脂肪性肝炎，导致纤维化、肝硬化和肝细胞癌。通过影像学和/或血清生物标志物的非侵入性检测可以评估晚期肝病的风险。只有在存在诊断疑问的情况下，才需要进行肝活检。NAFLD 的治疗方法与 T2D 缓解策略相似，侧重于通过生活方式改变、抗肥胖药物和/或减肥手术来减轻体重和控制合并症，以及具有明确疗效的 T2D 药物。
