Family & Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj,11942, Saudi Arabia.
Afr Health Sci. 2023 Jun;23(2):509-518. doi: 10.4314/ahs.v23i2.59.
NASH or "Non-alcoholic Steatohepatitis" is related to non-alcoholic fatty liver disease (NAFLD). The simultaneous occurrence of NASH and type 2 diabetes is common. However, only a limited number of studies have focused on the characteristics of patients with diabetes with or without NASH.
This systematic review summarises epidemiological evidence related to the prevalence and characteristics of NASH in patients with diabetes.
Different electronic databases PubMed, Scopus, and Google Scholar were searched for the published articles. Original studies conducted in patients with diabetes published in English were included in this review.
Thirteen studies were eligible for inclusion in this review. In patients with diabetes, increased BMI, overweight/obesity, increased HbA1c, increased serum cholesterol, and elevated liver enzyme levels have been strongly linked with NASH. Other significant characteristics include increasing age, being female, race(white), low HDL, metformin use, increased ferritin, and increased albumin levels. The prevalence of NASH ranged from 12% to 93.8%, the highest percentage was found in studies in Romania (87.1), and lowest in studies in India (12.5).
The incidence of NASH increases with age. Gender differences as a risk factor for NASH still need to be fully understood. This systematic review provides insight and strong indication to all patients with diabetes to visit hepatologists and screen for fatty liver disease. If steatosis is found on baseline ultrasound, a liver biopsy should be performed for timely management. At present, no NAFLD/NASH-specific medication on the market helps in treating the disease. New development of the drugs and ongoing research is important for the cure and treatment of NASH, with specific attention being provided to involve populations at high-risk.
NASH 或“非酒精性脂肪性肝炎”与非酒精性脂肪性肝病（NAFLD）有关。NASH 与 2 型糖尿病同时发生较为常见。然而，仅有少数研究关注了伴有或不伴有 NASH 的糖尿病患者的特征。
本系统综述总结了与糖尿病患者 NASH 患病率和特征相关的流行病学证据。
检索了不同的电子数据库 PubMed、Scopus 和 Google Scholar，以查找已发表的文章。本综述纳入了以糖尿病患者为对象、以英文发表的原始研究。
共有 13 项研究符合纳入本综述的标准。在糖尿病患者中，BMI 增加、超重/肥胖、HbA1c 升高、血清胆固醇升高和肝酶水平升高与 NASH 密切相关。其他重要特征包括年龄增长、女性、白种人、低 HDL、使用二甲双胍、铁蛋白升高和白蛋白水平升高。NASH 的患病率范围为 12%至 93.8%，罗马尼亚研究中的百分比最高（87.1%），印度研究中的百分比最低（12.5%）。
NASH 的发病率随年龄增长而增加。性别差异作为 NASH 的一个危险因素仍需要充分了解。本系统综述为所有糖尿病患者提供了一个重要的提示，建议他们去看肝病专家并筛查脂肪肝疾病。如果基线超声检查发现脂肪变性，应进行肝活检以进行及时管理。目前，市场上尚无针对 NAFLD/NASH 的特定药物可用于治疗该疾病。新的药物开发和正在进行的研究对于 NASH 的治疗和治愈非常重要，特别需要关注高风险人群。
