Wibawa I Dewa Nyoman, Mariadi I Ketut, Somayana Gde, Krisnawardani Kumbara Cokorda Istri Yuliandari, Sindhughosa Dwijo Anargha
Department of Internal Medicine, Gastroentero-hepatology Division, Udayana University, Faculty of Medicine, Denpasar 80233, Bali, Indonesia.
Internal Medicine Resident, Udayana University, Faculty of Medicine, Denpasar 80233, Bali, Indonesia.
World J Diabetes. 2023 May 15;14(5):549-559. doi: 10.4239/wjd.v14.i5.549.
Fatty liver disease is defined as liver condition characterized by hepatic steatosis, closely related to pathological conditions in type 2 diabetes and obesity. The high prevalence of fatty liver disease in obese patients with type 2 diabetes reached 70%, reflecting the importance of these conditions with fatty liver. Although the exact pathological mechanism of fatty liver disease, specifically non-alcoholic fatty liver disease (NAFLD) remains not completely revealed, insulin resistance is suggested as the major mechanism that bridged the development of NAFLD. Indeed, loss of the incretin effect leads to insulin resistance. Since incretin is closely related to insulin resistance and the resistance of insulin associated with the development of fatty liver disease, this pathway suggested a potential me-chanism that explains the association between type 2 diabetes and NAFLD. Furthermore, recent studies indicated that NAFLD is associated with impaired glucagon-like peptide-1, resulting in decreased incretin effect. Nevertheless, improving the incretin effect becomes a reasonable approach to manage fatty liver disease. This review elucidates the involvement of incretin in fatty liver disease and recent studies of incretin as the management for fatty liver disease.
脂肪性肝病被定义为以肝脂肪变性为特征的肝脏疾病，与2型糖尿病和肥胖症的病理状况密切相关。2型糖尿病肥胖患者中脂肪性肝病的高患病率达到70%，这反映了这些状况与脂肪性肝病的相关性。尽管脂肪性肝病，特别是非酒精性脂肪性肝病（NAFLD）的确切病理机制尚未完全揭示，但胰岛素抵抗被认为是连接NAFLD发展的主要机制。事实上，肠促胰素效应的丧失会导致胰岛素抵抗。由于肠促胰素与胰岛素抵抗以及与脂肪性肝病发展相关的胰岛素抵抗密切相关，该途径提示了一种潜在机制，解释了2型糖尿病与NAFLD之间的关联。此外，最近的研究表明，NAFLD与胰高血糖素样肽-1受损有关，导致肠促胰素效应降低。然而，改善肠促胰素效应成为治疗脂肪性肝病的合理方法。本综述阐明了肠促胰素在脂肪性肝病中的作用以及最近关于肠促胰素作为脂肪性肝病治疗方法的研究。
