胰岛素抵抗在 2 型糖尿病患者非酒精性脂肪肝发展过程中的作用：从工作台到患者护理

Q3 Medicine

Diabetes Spectrum Pub Date : 2024-02-01 DOI:10.2337/dsi23-0013

Juan Patricio Nogueira, Kenneth Cusi

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引用次数: 1

摘要

胰岛素抵抗与非酒精性脂肪肝（NAFLD）的发病机制及其从脂肪变性到脂肪性肝炎、肝硬化甚至肝细胞癌的发展过程都有关系，而肝细胞癌在 2 型糖尿病患者中更为常见。本文回顾了胰岛素抵抗在肥胖、2 型糖尿病、致动脉粥样硬化性血脂异常和高血压等代谢功能障碍中的作用，以及胰岛素抵抗如何通过促进葡萄糖毒性和脂肪毒性而成为非酒精性脂肪肝自然病史的驱动因素。作者还回顾了刺激脂肪性肝炎和肝纤维化进展的遗传和环境因素及其与心血管疾病的关系，并总结了支持使用吡格列酮或胰高血糖素样肽 1 受体激动剂等可降低胰岛素抵抗的糖尿病药物治疗非酒精性脂肪肝的指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Role of Insulin Resistance in the Development of Nonalcoholic Fatty Liver Disease in People With Type 2 Diabetes: From Bench to Patient Care

Insulin resistance is implicated in both the pathogenesis of nonalcoholic fatty liver disease (NAFLD) and its progression from steatosis to steatohepatitis, cirrhosis, and even hepatocellular carcinoma, which is known to be more common in people with type 2 diabetes. This article reviews the role of insulin resistance in the metabolic dysfunction observed in obesity, type 2 diabetes, atherogenic dyslipidemia, and hypertension and how it is a driver of the natural history of NAFLD by promoting glucotoxicity and lipotoxicity. The authors also review the genetic and environmental factors that stimulate steatohepatitis and fibrosis progression and their relationship with cardiovascular disease and summarize guidelines supporting the treatment of NAFLD with diabetes medications that reduce insulin resistance, such as pioglitazone or glucagon-like peptide 1 receptor agonists.

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来源期刊

Diabetes Spectrum Medicine-Internal Medicine

CiteScore

2.70

自引率

0.00%

发文量

期刊介绍： The mission of Diabetes Spectrum: From Research to Practice is to assist health care professionals in the development of strategies to individualize treatment and diabetes self-management education for improved quality of life and diabetes control. These goals are achieved by presenting review as well as original, peer-reviewed articles on topics in clinical diabetes management, professional and patient education, nutrition, behavioral science and counseling, educational program development, and advocacy. In each issue, the FROM RESEARCH TO PRACTICE section explores, in depth, a diabetes care topic and provides practical application of current research findings.