摘要
代谢相关脂肪性肝病(MAFLD)和2型糖尿病(T2DM)是全球常见的两大代谢性疾病,目前二者共病存在较高的流行率,同时能加速疾病的进展,给患者带来严重的疾病负担,是当前面临的重大公共卫生问题。MAFLD和T2DM相互影响,有着共同的发病机制。制定有效的MAFLD和T2DM共同管理策略是临床亟待解决的重要问题。本文围绕T2DM合并MAFLD的流行病学、发病机制、筛查监测、治疗等方面的最新进展进行详细阐述。本综述表明T2DM合并MAFLD为已成为临床的普遍现象,二者可互相影响,促进疾病的发生、发展。在T2DM患者中应开展MAFLD的筛查,无创诊断模型如纤维化指数4、脂肪肝纤维化评分等多种模型可用于常规筛查,但准确性有待进一步验证。此外,钠-葡萄糖共转运体2抑制剂、胰高血糖素样肽1受体激动剂等新型药物被证实可用于治疗T2DM合并MAFLD,同时能有效改善疾病的预后及预防心血管事件等。本文为T2DM合并MAFLD的临床诊疗策略的优化以及临床“糖肝共管”策略的制定提供了参考依据。
Metabolic dysfunction-associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM)are the two most common metabolic diseases worldwide.The coexistence of MAFLD and T2DM has a high prevalence rate and accelerates disease progression,imposing a significant disease burden on patients and posing a major public health challenge.MAFLD and T2DM mutually influence each other,sharing common pathogenic mechanisms.Developing effective co-management strategies for MAFLD and T2DM is a critical clinical priority.This review elaborates on recent advances in the epidemiology,pathogenesis,screening,monitoring,and treatment of T2DM combined with MAFLD.It highlights that the co-existence of T2DM and MAFLD has become a common clinical phenomenon with each condition exacerbating the development and progression of the other.Screening for MAFLD should be implemented in T2DM patients.Non-invasive diagnostic tools such as the Fibrosis 4 Index and NAFLD Fbrosis Score can be used for routine screening,though their accuracy requires further validation.Additionally,medications like sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists have been shown to improve outcomes in patients with T2DM and MAFLD,effectively preventing cardiovascular events.This review provides reference for the optimization of clinical diagnosis and treatment strategy of T2DM combined with MAFLD and the formulation of clinical"glycohepatic co-management"strategy.
作者
王鹏
仇丽霞
许姗姗
张洋
张晶
杜晓菲
WANG Peng;QIU Lixia;XU Shanshan;ZHANG Yang;ZHANG Jing;DU Xiaofei(The Third Unit,Department of Hepatology,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Beijing Institute of Liver Diseases,Beijing 100069,China)
出处
《中国全科医学》
北大核心
2025年第23期2846-2851,共6页
Chinese General Practice
基金
国家科技重大专项资助项目(2023ZD0508703)
北京市高层次公共卫生技术人才建设项目(03-23)
首都卫生发展科研专项资助项目(2024-1-4081,2024-2-1151)。
关键词
代谢相关脂肪性肝病
2型糖尿病
糖肝共管
代谢疾病
慢性肝病
Metabolic dysfunction-associated fatty liver disease
Type 2 diabetes mellitus
Co-management of MAFLD and T2DM
Metabolic diseases
Chronic liver disease
