scholarly journals Nonalcoholic Fatty Liver Disease, Diabetes Mellitus and Cardiovascular Disease: Newer Data

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
A. N. Mavrogiannaki ◽  
I. N. Migdalis

Nonalcoholic fatty liver disease (NAFLD) is the most common, chronic liver disease worldwide. Within this spectrum, steatosis alone is apparently benign, while nonalcoholic steatohepatitis may progress to cirrhosis and hepatocellular carcinoma. NAFLD is strongly associated with obesity, dyslipidemia, type 2 diabetes mellitus, and cardiovascular disease. The pathogenesis of hepatic steatosis is not clearly known, but its main characteristics are considered insulin resistance, mitochondrial dysfunction, increased free fatty acids reflux from adipose tissue to the liver, hepatocyte lipotoxicity, stimulation of chronic necroinflammation, and fibrogenic response. With recent advances in technology, advanced imaging techniques provide important information for diagnosis. There is a significant research effort in developing noninvasive monitoring of disease progression to fibrosis and response to therapy with potential novel biomarkers, in order to facilitate diagnosis for the detection of advanced cirrhosis and to minimize the need of liver biopsy. The identification of NAFLD should be sought as part of the routine assessment of type 2 diabetics, as sought the microvascular complications and cardiovascular disease, because it is essential for the early diagnosis and proper intervention. Diet, exercise training, and weight loss provide significant clinical benefits and must be considered of first line for treating NAFLD.

2017 ◽  
Vol 28 (1) ◽  
pp. 187-194 ◽  
Author(s):  
Everton Cazzo ◽  
Laísa Simakawa Jimenez ◽  
Martinho Antonio Gestic ◽  
Murillo Pimentel Utrini ◽  
Fábio Henrique Mendonça Chaim ◽  
...  

2021 ◽  
pp. 79-83
Author(s):  
Halyna Mykhalchyshyn

Nowadays we notice the increase of cases that combine type two diabetes mellitus, and nonalcoholic fatty liver disease. As a result, the course of disease aggravates. The pathogenesis, diagnoses and treatment of NAFLD remain unclear. The objective: of our study is to determine the clinical efficacy of an improved therapeutic measures set in patients with type 2 diabetes and NAFLD. Materials and methods. We’ve examined 132 patients with type 2 diabetes mellitus and NAFLD. All patients gave their consent to participate in the study. They also received all necessary nutrition and workout recommendations. We split the patients into two groups. First group patients (n=37) received antihyperglycemic drugs (metformin, gliclazide or glimepiride). Patients of the second group (n=95) additionally received DPP-4 inhibitors (saxagliptin or sitagliptin), atorvastatin, and the multiprobiotic. Patients of the second group were divided into 2 subgroups: 2A group with standard level of transaminases, and 2B group with an increased level of transaminases accordingly. Results. Improved set of therapeutic measures revealed distinctively positive effect on the dynamics of clinical manifestation of lesions of the hepatobiliary system in patients with diabetes. There were no such changes in another group. Under the influence of complex treatment in the second group of patients, the functional state of liver improved due to a significant decrease of ALT, AST, TG and VLDL levels in the blood serum. Size of the liver decreased, liver stiffness indicators improved according to shear wave elastography data. Conclusions. Combined therapy, which includes DPP-4 inhibitors, statins and multiperiodic is effective in the treatment of patients with type two diabetes and nonalcoholic fatty liver disease.


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