The Janus of a disease: Diabetes and metabolic dysfunction-associated fatty liver disease

• Published in: Annals of hepatology Vol. 29; no. 4; p. 101501
• Main Authors: Barrera, Francisco, Uribe, Javier, Olvares, Nixa, Huerta, Paula, Cabrera, Daniel, Romero-Gómez, Manuel
• Format: Journal Article
• Language: English
• Published: Mexico Elsevier España, S.L.U 01.07.2024; Elsevier
• Subjects: Diabetes; Fatty liver; Hepatic steatosis; Insulin resistance; MASLD; Metabolic associated fatty liver disease; Metabolic syndrome; WFA þ. -M2BP; ALT; HR; PDFF; PPAR; VLDL; MetALD; US; Metabolic associated fatty liver disease; SREBP; IL-1; GPBAR1; HCC; Hepatic steatosis; MASLD; IL-12; IL-6; CVD; CAP; GCRK; DALYs; BA; 2D-SWE; T2DM; FXR; RCT; MRI; MASH; HSD17B13; Metabolic syndrome; 95 % CI; MBOAT; Fatty liver; MCP1; LDL; CKD; CDCA; NOD-like receptors; GLP-1 RA; OR; ANGPT2; GLP-1; ELF score; TM6SF2; TGR5; ChREBP; TNFa; DNA; FGF19; VCTE; PNPLA3; NIT; Insulin resistance; Diabetes; FGFR4; TLRs; ADA; Fatty Liver; Hepatic Steatosis; Metabolic Syndrome; Insulin Resistance; Metabolic Associated Fatty Liver Disease
• ISSN: 1665-2681; 2659-5982
• DOI: 10.1016/j.aohep.2024.101501

Metabolic Dysfunction-Associated Fatty Liver Disease and Diabetes Mellitus are two prevalent metabolic disorders that often coexist and synergistically contribute to the progression of each other. Several pathophysiological pathways are involved in the association, including insulin resistance, inflammation, and lipotoxicity, providing a foundation for understanding the complex interrelationships between these conditions. The presence of MASLD has a significant impact on diabetes risk and the development of microvascular and macrovascular complications, and diabetes significantly contributes to an increased risk of liver fibrosis progression in MASLD and the development of hepatocellular carcinoma. Moreover, both pathologies have a synergistic effect on cardiovascular events and mortality. Therapeutic interventions targeting MASLD and diabetes are discussed, considering lifestyle modifications, pharmacological agents, and emerging treatment modalities. The review also addresses the challenges in managing these comorbidities, such as the need for personalized approaches and the potential impact on cardiovascular health. The insights gleaned from this analysis can inform clinicians, researchers, and policymakers in developing integrated strategies for preventing, diagnosing, and managing these metabolic disorders.