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代谢功能障碍相关脂肪性肝病在 2 型糖尿病中的作用:韩国糖尿病协会脂肪肝研究组的综述和立场声明。

Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Mellitus: A Review and Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.

出版信息

Diabetes Metab J. 2024 Nov;48(6):1015-1028. doi: 10.4093/dmj.2024.0541. Epub 2024 Nov 21.


DOI:10.4093/dmj.2024.0541
PMID:39610131
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11621661/
Abstract

Since the role of the liver in metabolic dysfunction, including type 2 diabetes mellitus, was demonstrated, studies on non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) have shown associations between fatty liver disease and other metabolic diseases. Unlike the exclusionary diagnostic criteria of NAFLD, MAFLD diagnosis is based on the presence of metabolic dysregulation in fatty liver disease. Renaming NAFLD as MAFLD also introduced simpler diagnostic criteria. In 2023, a new nomenclature, steatotic liver disease (SLD), was proposed. Similar to MAFLD, SLD diagnosis is based on the presence of hepatic steatosis with at least one cardiometabolic dysfunction. SLD is categorized into metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related/-associated liver disease, alcoholrelated liver disease, specific etiology SLD, and cryptogenic SLD. The term MASLD has been adopted by a number of leading national and international societies due to its concise diagnostic criteria, exclusion of other concomitant liver diseases, and lack of stigmatizing terms. This article reviews the diagnostic criteria, clinical relevance, and differences among NAFLD, MAFLD, and MASLD from a diabetologist's perspective and provides a rationale for adopting SLD/MASLD in the Fatty Liver Research Group of the Korean Diabetes Association.

摘要

自从肝脏在代谢功能障碍(包括 2 型糖尿病)中的作用被证实以来,对非酒精性脂肪性肝病(NAFLD)和代谢相关脂肪性肝病(MAFLD)的研究表明,脂肪性肝病与其他代谢性疾病之间存在关联。与 NAFLD 的排他性诊断标准不同,MAFLD 的诊断基于脂肪性肝病中代谢失调的存在。将 NAFLD 重新命名为 MAFLD 也引入了更简单的诊断标准。2023 年,提出了一种新的命名法,即脂肪变性性肝病(SLD)。与 MAFLD 相似,SLD 的诊断基于至少有一种心血管代谢功能障碍的肝脂肪变性。SLD 分为代谢相关脂肪变性性肝病(MASLD)、代谢功能障碍和酒精相关/相关肝病、酒精相关肝病、特定病因 SLD 和隐匿性 SLD。由于其简洁的诊断标准、排除其他伴随的肝脏疾病以及没有污名化的术语,许多领先的国家和国际协会采用了 MASLD 这一术语。本文从糖尿病学家的角度回顾了 NAFLD、MAFLD 和 MASLD 的诊断标准、临床相关性和差异,并为韩国糖尿病协会脂肪肝病研究组采用 SLD/MASLD 提供了依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2400/11621661/4be3748ac422/dmj-2024-0541f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2400/11621661/67a1fecf211e/dmj-2024-0541f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2400/11621661/12bbec9b2ce8/dmj-2024-0541f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2400/11621661/44dc1c577033/dmj-2024-0541f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2400/11621661/4be3748ac422/dmj-2024-0541f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2400/11621661/67a1fecf211e/dmj-2024-0541f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2400/11621661/12bbec9b2ce8/dmj-2024-0541f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2400/11621661/44dc1c577033/dmj-2024-0541f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2400/11621661/4be3748ac422/dmj-2024-0541f4.jpg

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引用本文的文献

[1]
Association of temporal MASLD with type 2 diabetes, cardiovascular disease and mortality.

Cardiovasc Diabetol. 2025-7-15

[2]
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Diabetes Metab J. 2025-5

[3]
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Diabetes Metab J. 2025-5

[4]
Bioelectrical impedance analysis parameters are superior to liver enzymes in predicting metabolic dysfunction-associated steatotic liver disease in young adults.

Intern Emerg Med. 2025-4

本文引用的文献

[1]
EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD).

J Hepatol. 2024-9

[2]
Substantial overlap between NAFLD and MASLD with comparable disease severity and non-invasive test performance: An analysis of the Indian Consortium on MASLD (ICOM-D) cohort.

J Hepatol. 2024-10

[3]
Epidemiology, screening, and co-management of type 2 diabetes mellitus and metabolic dysfunction-associated steatotic liver disease.

Hepatology. 2024-5-8

[4]
MAFLD identifies patients with significant hepatic fibrosis better than MASLD.

Hepatol Int. 2024-6

[5]
MAFLD predicts cardiovascular disease risk better than MASLD.

Liver Int. 2024-7

[6]
The Global Epidemiology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Among Patients With Type 2 Diabetes.

Clin Gastroenterol Hepatol. 2024-10

[7]
Insulin Resistance, Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: Clinical and Experimental Perspective.

Diabetes Metab J. 2024-5

[8]
Clinical profiles and mortality rates are similar for metabolic dysfunction-associated steatotic liver disease and non-alcoholic fatty liver disease.

J Hepatol. 2024-5

[9]
Steatotic liver disease predicts cardiovascular disease and advanced liver fibrosis: A community-dwelling cohort study with 20-year follow-up.

Metabolism. 2024-4

[10]
Prognosis of biopsy-confirmed metabolic dysfunction- associated steatotic liver disease: A sub-analysis of the CLIONE study.

Clin Mol Hepatol. 2024-4

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