Non-alcoholic fatty liver disease and diabetes

被引:413
作者
Hazlehurst, Jonathan M. [1 ]
Woods, Conor [1 ]
Marjot, Thomas [2 ]
Cobbold, Jeremy F. [2 ]
Tomlinson, Jeremy W. [1 ]
机构
[1] Univ Oxford, Churchill Hosp, Oxford Ctr Diabet Endocrinol & Metab, NIHR Oxford Biomed Res Ctr, Oxford OX3 7LE, England
[2] Oxford Univ Hosp NHS Trust, Dept Gastroenterol, Oxford OX3 9DU, England
来源
METABOLISM-CLINICAL AND EXPERIMENTAL | 2016年 / 65卷 / 08期
基金
英国惠康基金;
关键词
NAFLD; NASH; Diabetes; Insulin resistance; Diabetes complications; HEPATIC INSULIN SENSITIVITY; COTRANSPORTER; 2; INHIBITORS; PLACEBO-CONTROLLED TRIAL; HEPATOCELLULAR-CARCINOMA; RISK-FACTOR; MAGNETIC-RESONANCE; PEPTIDE-1; RECEPTOR; GLUCOSE-METABOLISM; BARIATRIC SURGERY; ADIPOSE-TISSUE;
D O I
10.1016/j.metabol.2016.01.001
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2DM) are common conditions that regularly co-exist and can act synergistically to drive adverse outcomes. The presence of both NAFLD and T2DM increases the likelihood of the development of complications of diabetes (including both macro- and micro- vascular complications) as well as augmenting the risk of more severe NAFLD, including cirrhosis, hepatocellular carcinoma and death. The mainstay of NAFLD management is currently to reduce modifiable metabolic risk Achieving good glycaemic control and optimising weight loss are pivotal to restricting disease progression. Once cirrhosis has developed, it is necessary to screen for complications and minimise the risk of hepatic decompensation. Therapeutic disease modifying options for patients with NAFLD are currently limited. When diabetes and NAFLD co-exist, there are published data that can help inform the clinician as to the most appropriate oral hypoglycaemic agent or injectable therapy that may improve NAFLD, however most of these data are drawn from observations in retrospective series and there is a paucity of well-designed randomised double blind placebo controlled studies with gold-standard end-points. Furthermore, given the heterogeneity of inclusion criteria and primary outcomes, as well as duration of followup, it is difficult to draw robust conclusions that are applicable across the entire spectrum of NAFLD and diabetes. In this review, we have summarised and critically evaluated the available data, with the aim of helping to inform the reader as to the most pertinent issues when managing patients with co-existent NAFLD and T2DM. (C) 2016 The Authors. Published by Elsevier Inc.
引用
收藏
页码:1096 / 1108
页数:13
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