[非酒精性脂肪性肝病与糖尿病：糟糕的组合]
[Non-Alcoholic Fatty Liver Disease and Diabetes: the bad marriage].
作者信息
Nascè Alberto, Memaj Plator, Jornayvaz François R
机构信息
Service d'endocrinologie, diabétologie, nutrition et éducation thérapeutique du patient, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14.
Service de médecine interne générale, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14.
出版信息
Rev Med Suisse. 2023 May 31;19(829):1090-1093. doi: 10.53738/REVMED.2023.19.829.1090.
NAFLD, whose prevalence keeps growing, is strongly linked with type 2 diabetes (T2D) through insulin resistance and oxidative stress. A multifactorial association with T1D has recently been found. NAFLD screening aims to identify non-alcoholic steatohepatitis (NASH) and fibrosis and to better refer to liver specialists. It is recommended for patients at higher risk, such as those with T2D. NAFLD treatment cornerstone is weight loss, obtained through lifestyle interventions, obesity pharmacotherapy, and bariatric surgery. When treating patients suffering from NAFLD and T2D, we should prioritize GLP-1 analogues and PPAR agonists, capable of regressing NASH, and SGLT2i, efficient on liver steatosis.
非酒精性脂肪性肝病（NAFLD）的患病率持续上升，通过胰岛素抵抗和氧化应激与2型糖尿病（T2D）密切相关。最近发现它与1型糖尿病（T1D）存在多因素关联。NAFLD筛查旨在识别非酒精性脂肪性肝炎（NASH）和纤维化，并更好地转诊至肝脏专科医生。建议对高危患者进行筛查，如T2D患者。NAFLD的治疗基石是通过生活方式干预、肥胖药物治疗和减肥手术实现体重减轻。在治疗患有NAFLD和T2D的患者时，我们应优先选择能够使NASH消退的胰高血糖素样肽-1（GLP-1）类似物和过氧化物酶体增殖物激活受体（PPAR）激动剂，以及对肝脏脂肪变性有效的钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）。
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