Type 2 diabetes mellitus, non-alcoholic fatty liver disease and cardiovascular disease: causal relationships and the role of anti-diabetic drugs

All over the world, the number of patients suffering from type 2 diabetes mellitus, non-alcoholic fatty liver disease and cardiovascular diseases is increasing every day. At the same time, they not only coexist as independent diseases, but also have many points of intersection in pathogenesis and progression, such as dyslipidemia, prothrombotic processes, insulin resistance and hyperglycemia, chronic subclinical inflammation. Thus, they make each other’s course heavier and increase the number of adverse outcomes, including general and cardiovascular mortality. All this is an incentive for a more detailed study of the complex relationship of these diseases, in order to optimize diagnostics and treatment. Due to the urgency of this issue, the effect of most of the currently existing hypoglycemic drugs on non-alcoholic fatty liver disease and cardiovascular diseases has already been reflected in many studies and meta-analyses. This review will cover the main groups of drugs, namely biguanides, thiazolidinediones, sodium-glucose cotransporter type 2 inhibitors, dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists. The use of which is approved in comorbid patients according to these conditions pathogenesis.