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Abstract Details
When Sugar Reaches the Liver: Phenotypes of Patients with Diabetes and NAFLD
J Clin Med. 2022 Jun 8;11(12):3286. doi: 10.3390/jcm11123286.
1Endocrinology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain.
2Vall d'Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain.
3Medicine Department Bellaterra, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain.
4Liver Unit, Vall d'Hebron University Hospital, 08035 Barcelona, Spain.
5Spanish Network of Biomedical Research Centers, Diabetes and Metabolic Associated Disorders (CIBERdem), 28029 Madrid, Spain.
6Biochemistry Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain.
7Biochemistry and Molecular Biology Department, Universitat Autònoma de Barcelona (UAB), Bellaterra, 08193 Barcelona, Spain.
8Spanish Network of Biomedical Research Centers, Liver and Digestive Diseases (CIBERehd), 28801 Madrid, Spain.
Abstract
Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) have been traditionally linked to one another. Recent studies suggest that NAFLD may be increasingly common in other types of diabetes such as type 1 diabetes (T1DM) and less frequently ketone-prone and Maturity-onset Diabetes of the Young (MODY) diabetes. In this review, we address the relationship between hyperglycemia and insulin resistance and the onset and progression of NAFLD. In addition, despite the high rate of patients with T2DM and other diabetes phenotypes that can alter liver metabolism and consequently develop steatosis, fibrosis, and cirrhosis, NALFD screening is not still implemented in the daily care routine. Incorporating a clinical algorithm created around a simple, non-invasive, cost-effective model would identify high-risk patients. The principle behind managing these patients is to improve insulin resistance and hyperglycemia states with lifestyle changes, weight loss, and new drug therapies.