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NAFLD and diabetes mellitus

医学 胰岛素抵抗 2型糖尿病 糖尿病 脂肪因子 肝硬化 生物信息学 内科学 疾病 脂肪肝 内分泌学 生物
作者
Herbert Tilg,Alexander R. Moschen,Michael Roden
出处
期刊:Nature Reviews Gastroenterology & Hepatology [Springer Nature]
卷期号:14 (1): 32-42 被引量:787
标识
DOI:10.1038/nrgastro.2016.147
摘要

The association between NAFLD and diabetes mellitus has garnered increasing attention in the past few years. In this Review, Tilg and colleagues explore in detail the molecular mechanisms linking NAFLD and diabetes mellitus, and discuss clinical aspects arising from the interaction of both diseases. The liver constitutes a key organ in systemic metabolism, contributing substantially to the development of insulin resistance and type 2 diabetes mellitus (T2DM). The mechanisms underlying these processes are not entirely understood, but involve hepatic fat accumulation, alterations of energy metabolism and inflammatory signals derived from various cell types including immune cells. Lipotoxins, mitochondrial function, cytokines and adipocytokines have been proposed to play a major part in both NAFLD and T2DM. Patients with NAFLD are commonly insulin resistant. On the other hand, a large number of patients with T2DM develop NAFLD with its inflammatory complication, NASH. The high incidence of NASH in patients with T2DM leads to further complications, such as liver cirrhosis and hepatocellular carcinoma, which are increasingly recognized. Therapeutic concepts such as thiazolidinediones (glitazones) for treating T2DM also show some efficacy in the treatment of NASH. This Review will describe the multifaceted and complex interactions between the liver and T2DM.
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