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Is nonalcoholic fatty liver disease a complication of diabetes?
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摘要:
非酒精性脂肪性肝病(NAFLD)虽然是一种肝脏疾病,但越来越受到内分泌学界的重视。糖尿病的代谢状态与NAFLD的病理之间存在复杂的相互作用,促进彼此的发生。在2型糖尿病(T2DM)人群中,脂肪肝伴随率高达57%～80%,合并糖尿病的NAFLD患者可能更容易发生非酒精性脂肪性肝炎(NASH)、肝纤维化等进展性肝病。而NAFLD也促使糖尿病患者糖脂代谢紊乱进一步恶化,以及糖尿病慢性大血管和微血管并发症的发生发展。上述依据支持NASH应被视为T2DM并发症的观点。临床上,一旦T2DM诊断明确,应积极评估NASH或进展性纤维化风险,并积极干预。
Abstract:Although nonalcoholic fatty liver disease( NAFLD) is a liver disease,it has attracted more and more attention among endocrinologists. There are complex interactions between the metabolic status of diabetes and the pathology of NAFLD,and they promote the development of each other. In the population with type 2 diabetes mellitus( T2 DM),the incidence rate of NAFLD is as high as 57%-80%,and NAFLD patients with diabetes are more likely to develop progressive liver diseases such as nonalcoholic steatohepatitis( NASH) and liver fibrosis. NAFLD also leads to the deterioration of glucose and lipid metabolism disorder in diabetes patients,as well as the development and progression of chronic macrovascular and microvascular complications in diabetes. The above evidence supports the view that NASH should be considered a complication of T2 DM. Once a definite diagnosis of T2 DM is made in clinical practice,the risk of NASH or progressive fibrosis should be evaluated and intervention should be given as early as possible.
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