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Diabetes and NAFLD:a high-risk cohort with definite therapeutic potential

Hepatoma Research 2020年第12期6卷 1-11页

作者： Lucia Brodosi alessandra musio Francesca alessandra Barbanti Dorina Mita Giulio Marchesini Maria Letizia Petroni Department of Medical and Surgical Sciences “Alma Mater”UniversityBologna 40138Italy Azienda Ospedaliero-Universitaria di Bologna Bologna 40138Italy.

Despite the fact that non-alcoholic fatty liver disease(NAFLD)and its severe clinical forms[non-alcoholic steatohepatitis(NASH)and NASH-cirrhosis]are highly prevalent in the general population,there are no licensed drugs for NAFLD,and lifestyle intervention remains the only treatment accepted by international *** is despite massive investments in research by pharmaceutical *** the presence of type 2 diabetes,novel anti-diabetic drugs offer an opportunity to reduce the burden of NAFLD,by adequate control of glucose and lipid metabolism,also reducing the risk of NASH progression,advanced fibrosis,and finally hepatocellular *** extensively reviewed the literature,based either on registration studies,ad hoc randomized studies or real-world data,to define the effectiveness of anti-diabetic drugs in the treatment of NAFLD and prevention of hepatocellular carcinoma(HCC).Metformin provides the best evidence for decreased risk of HCC,pioglitazone was associated with decreased progression to fibrosis,glucagon-like peptide-1 receptor agonists offer a possible opportunity to reduce NAFLD progression coupled with a definite protection for cardiovascular outcomes,and sodium-glucose cotransporter-2 inhibitors are likely to reduce lipid burden,simultaneously reducing the risk of progressive renal and heart *** the latter two drug classes,the effects on NAFLD might largely explained by decreased body weight,in keeping with the beneficial effects of intensive lifestyle intervention.

关键词： Metformin pioglitazone incretins DPP-4 inhibitors GLP-1 receptor agonists SGLT-2 inhibitors insulin cirrhosis

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