非酒精性脂肪肝:2型糖尿病发病的始动环节?

Non-alcoholic fatty liver disease: a starting point of the onset of type 2 diabetes mellitus?

随着人们生活方式的改变,非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)已为我国最常见的肝脏疾病.作为代谢性疾病,NAFLD与2型糖尿病(type 2 diabetes mellitus,T2DM)发病密切相关.NAFLD患者的T2DM发病风险增加近5倍,被认为是T2DM发病的独立危险因素.因此,深入认识NAFLD与T2DM的关系有助于我们重新认识T2DM的发病机制,为制定T2DM防治措施提供依据.本文从肝脏脂代谢紊乱导致胰岛素抵抗、炎性因子释放增加、影响机体整体代谢、损失胰岛β细胞功能、影响肠促胰岛素分泌和降低脂肪组织胰岛素敏感性等几个方面,探讨NAFLD在促发T2DM中的始动作用.

With changes in lifestyle, non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease. As metabolic diseases, NAFLD is strongly associated with type 2 diabetes mellitus (T2DM). An individual’s risk of developing diabetes is increased approximately 5-fold if they have NAFLD. Numerous studies suggest that NAFLD has a causal role in the onset of T2DM.Therefore, unraveling the relationship between lipid metabolism disturbance and T2DM contributes to the understanding of the etiology of T2DM and the intervention of T2DM.This paper reviewed the mechanisms underlying the pathogenesis of T2DM by NAFLD such as insulin resistance, increased inflammatory mediator release, induction of metabolic dysfunction by hepatokines, impaired β-cell function, influence on incretin by liver and decreased insulin sensitivity in adipose tissue.