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Vol. 46. Issue 10.
Pages 815-825 (December 2023)
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Vol. 46. Issue 10.
Pages 815-825 (December 2023)
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NAFLD and type 2 diabetes: A practical guide for the joint management
Esteatosis hepática metabólica y diabetes mellitus tipo 2: Una guía práctica para el manejo conjunto
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Idoia Genuaa,b,1, Paula Iruzubietac,1, Juan Carlos Rodríguez-Duquec, Antonio Péreza,d,f,
Corresponding author
aperez@santpau.cat

Corresponding authors.
, Javier Crespoc,f,
Corresponding author
javiercrespo1991@gmail.com

Corresponding authors.
a Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona (UAB), Barcelona, Spain
b Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
c Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
d Diabetes and Associated Metabolic Diseases CIBER (CIBERDEM), Spain
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Table 1. Effects of noninsulin glucose-lowering agents.
Abstract

Non-alcoholic fatty liver disease (NAFLD) is becoming a major cause of liver disease-related morbidity, as well as mortality. Importantly, NAFLD is considered a mediator of systemic diseases including cardiovascular disease. Its prevalence is expected to increase, mainly due to its close association with obesity and type 2 diabetes mellitus (T2D). In addition, T2D and NAFLD share common pathophysiological mechanisms, and one can lead to or worsen the other. Therefore, a close collaboration between primary care physician, endocrinologists and hepatologists is essential to optimize the management of patients with NAFLD and T2D. Here, we summarize relevant aspects about NAFLD and T2D that all clinician managing these patients should know as well as current therapeutic options for the treatment of T2D associated with NAFLD.

Keywords:
Non-alcoholic fatty liver disease
Type 2 diabetes mellitus
Fibrosis screening
Pioglitazone
Glucagon-like peptide-1 receptor agonists
Abbreviations:
AACE
AASLD
BMI
CAP
CVD
CVR
DPP-4
EASD
EASO
EASL
EBMT
ELF
ESG
FFA
FIB-4
GIP
GLP-1
GLP-1 RA
HbA1c
HCC
NAFL
NAFLD
NASH
NFS
NPV
MetS
SGLT2
T2D
TBWL
VCTE
Resumen

La esteatosis hepática metabólica (EHmet) se está convirtiendo en una de las causas más importantes de morbimortalidad relacionada con las enfermedades hepáticas. Es importante destacar que la EHmet se considera un mediador de enfermedades sistémicas, incluidas las enfermedades cardiovasculares. Se espera que su prevalencia aumente, principalmente debido a su estrecha relación con la obesidad y la diabetes mellitus tipo 2 (DM2). Además, la DM2 y la EHmet comparten mecanismos fisiopatológicos comunes y una puede provocar o empeorar la otra. Por lo tanto, una estrecha colaboración entre el médico de atención primaria, endocrinólogos y hepatólogos es fundamental para optimizar el manejo de los pacientes con EHmet y DM2. En esta guía resumimos aspectos relevantes sobre EHmet y DM2 que todo médico que maneja a estos pacientes debe conocer, así como las opciones terapéuticas actuales para el tratamiento de DM2 asociada a EHmet.

Palabras clave:
Esteatosis hepática metabólica
Diabetes mellitus tipo 2
Cribado de fibrosis hepática
Pioglitazona
Agonistas del receptor del péptido similar al glucagón tipo 1

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