Michalopoulou Eleni, Thymis John, Lampsas Stamatios, Pavlidis George, Katogiannis Konstantinos, Vlachomitros Dimitrios, Katsanaki Eleni, Kostelli Gavriella, Pililis Sotirios, Pliouta Loukia, Kountouri Aikaterini, Papanikolaou Ioannis S, Lambadiari Vaia, Ikonomidis Ignatios
2nd Cardiology Department, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462 Athens, Greece.
Diabetes Center, 2nd Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462 Athens, Greece.
J Clin Med. 2025 Jan 10;14(2):428. doi: 10.3390/jcm14020428.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global health concern, and it is not only the keystone precursor of eventual liver-related morbidity, but it also places patients at considerably higher cardiovascular risk, which is still a leading cause of death in these patients. The most important common underlying pathophysiological mechanisms in these diseases are primarily related to insulin resistance, chronic inflammation and oxidative stress. The presence of MASLD with cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) elevates the risk for poor outcomes, thus this review highlights a method to the therapeutic approaches. Given the intertwined nature of MASLD, T2DM, and CVD, there is an urgent need for therapeutic strategies that address all three conditions. Although lifestyle changes are important as treatment, medication plays a crucial role in managing hyperglycemia, enhancing liver function and lowering cardiovascular risk. The onset and progression of MASLD should be addressed through a multifaceted therapeutic approach, targeting inflammatory, immune, metabolic, oxidative stress, hormonal and gutaxis pathways, alongside the treatment strategies for T2DM. In this review, we discuss the effects of antidiabetic drugs with an impact on both liver outcomes and cardiovascular risk in patients affected by MASLD, T2DM and CDV.
代谢功能障碍相关脂肪性肝病（MASLD）是一个新出现的全球健康问题，它不仅是最终肝脏相关发病的关键先兆，还使患者面临相当高的心血管风险，而心血管疾病仍是这些患者的主要死因。这些疾病最重要的共同潜在病理生理机制主要与胰岛素抵抗、慢性炎症和氧化应激有关。MASLD合并心血管疾病（CVD）和2型糖尿病（T2DM）会增加不良结局的风险，因此本综述重点介绍了一种治疗方法。鉴于MASLD、T2DM和CVD之间相互交织的性质，迫切需要针对这三种情况的治疗策略。虽然生活方式改变作为治疗手段很重要，但药物在控制高血糖、改善肝功能和降低心血管风险方面起着关键作用。MASLD的发生和进展应通过多方面的治疗方法来解决，针对炎症、免疫、代谢、氧化应激、激素和肠道轴途径，同时采用T2DM的治疗策略。在本综述中，我们讨论了抗糖尿病药物对受MASLD、T2DM和CDV影响的患者肝脏结局和心血管风险的影响。
