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Semin Liver Dis 2022; 42(01): 048-060
DOI: 10.1055/s-0041-1732354
Review Article

Novel Antidiabetic Strategies and Diabetologists' Views in Nonalcoholic Steatohepatitis

Sabine Kahl
1   Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
2   German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
3   Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
,
Jennifer Pützer
1   Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
2   German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
,
Michael Roden
1   Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
2   German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
3   Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Abstract

Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide with high prevalence, especially in individuals with obesity and type 2 diabetes. Among individuals with type 2 diabetes, the severe insulin resistant subgroup has the greatest risk of NAFLD, likely due to dysfunctional adipose tissue mass but also genetic factors, and may progress earlier to inflammatory and profibrotic nonalcoholic steatohepatitis (NASH). NASH has been associated with increased liver-related as well as cardiovascular morbidity and mortality. International diabetes associations recommend certain screening and treatment strategies for NASH in type 2 diabetes, which, however, bear several limitations such as lack of accurate noninvasive diagnostic tools and targeted treatments. Currently, antihyperglycemic drug concepts based on glucagon-like peptide-1 receptor agonists and sodium glucose cotransporter 2 inhibitors offer metabolic as well as cardiorenal benefits and provide treatment options for both hyperglycemia and NASH in type 2 diabetes.

Keywords

nonalcoholic fatty liver disease - adipose tissue insulin resistance - glucagon-like peptide-1 receptor agonists - sodium glucose cotransporter 2 inhibitors - weight loss


Publication History

Article published online:
21 July 2021

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