FOCUS ON THE TYPE 2 DIABETES PATIENT WITH LIVER DISEASE: EMPHASIS ON NONALCOHOLIC FATTY LIVER DISEASE (NAFLD)

摘要

Patients with diabetes are at increased risk for a spectrum of liver disorders and diseases, including elevated liver enzymes, hepatitis C, NAFLD and nonalcoholic steatohepatitis (NASH), hepatocellular carcinoma, cirrhosis, and acute liver failure (1-6). NAFLD is the most common liver condition associated with T2DM (1). The prevalence of NAFLD in diabetes is estimated at 34% to 74% but increases to nearly 100% when both diabetes and obesity are present (1). NAFLD is diagnosed based on the clinical findings of hepatic fat accumulation (steatosis) in the absence of another cause of liver disease, such as hepatitis or alcohol abuse. NASH, on the other hand, is diagnosed based on histologic findings of hepatic steatosis plus lobular inflammation, hepatocellular ballooning, or fibrosis (7).