Nonalcoholic fatty liver disease in patients with type 2 diabetes: a review article
DOI:
https://doi.org/10.24265/horizmed.2023.v23n2.13Keywords:
diabetes mellitus, type 2, fibrosis, fatty liverAbstract
Nonalcoholic fatty liver disease (NAFLD) is caused by a build-up of triglyceride macrovesicles in the liver not related to
other etiologies such as alcoholism, medications or genetic disorders. The spectrum of this condition includes nonalcoholic steatohepatitis (NASH) and simple fatty liver.
In 2020, an international panel of experts proposed a new name for this entity and considered that the term “metabolic
associated fatty liver disease” (MAFLD) would be the most appropriate to refer to a comprehensive but simple set of
criteria for the diagnosis of MAFLD, which is not related to the amount of alcohol consumption and can occur in patients
in any clinical setting.
NAFLD is a manifestation of metabolic syndrome and shows high prevalence and risk of rapid progression in patients
with type 2 diabetes (T2DM). The current model considers that this process occurs as a consequence of “multiple hits” that could precede the fatty liver disease, this being the most appropriate explanation for the evolution of NAFLD in an
inflammatory state. T2DM worsens NAFLD, leading to hyperglycemia and thus building a vicious circle.
As for patients with diabetes, the risk of fibrosis must be assessed due to its impact on increased cardiovascular risk and
progression of liver disease. This task may be accomplished through non-invasive tests such as hepatic fibrosis biomarkers
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