糖尿病非酒精性脂肪肝防治新进展  

Prevention and treatment of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

作　　者：周赛君[1] 于德民[1] 于珮[1] 

机构地区：[1]天津医科大学代谢病医院糖尿病肾病血液透析科卫生部激素与发育重点实验室,天津市300070

出　　处：《世界华人消化杂志》2015年第32期5113-5122,共10页World Chinese Journal of Digestology

基　　金：天津市科技支撑重大基金资助项目;No.13ZCZDSY01300;天津市卫生局科技支撑重大基金资助项目;No.2012KG135~~

摘　　要：非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)在2型糖尿病(type 2 diabetes mellitus,T2DM)人群中广泛流行.胰岛素抵抗架起了T2DM和NAFLD间相互联系的病生理桥梁.两者合并发病,预示着病情的加重和死亡风险的增加,有效防治T2DM患者NAFLD刻不容缓.胰高糖素样多肽-1(glucagon like peptide-1,GLP-1)受体激动剂、二肽基肽酶-4(dipeptidyl peptidase-4,DPP-4)抑制剂等药物的问世给T2DM合并NAFLD的防治带来的新希望;外科减肥手术的成功开展为肥胖的T2DM合并NAFLD的治疗提供强有力的手段;脂联素、成纤维细胞生长因子21(fibroblast growth factor21,FGF21)等脂肪因子的发现为研发防治T2DM合并NAFLD的药物提供新的方向.本文结合T2DM合并NAFLD的流行病学、二者的病生理联系等特点,系统阐述了T2DM患者NAFLD治疗手段以及研究现状.Nonalcoholic fatty liver disease（NAFLD） is frequently seen in the type 2 diabetes mellitus（T2DM） population.Insulin resistance is the pathophysiologic bridge which links T2 DM and NAFLD.Coexistence of both diseases indicates more severe diseases and higher risk of death.As a result,it is urgent to effectively control NAFLD in patients with T2 DM.The advent of glucagon like peptide-1（GLP-1） agonists and dipeptidyl peptidase-4（DPP-4） inhibitors brings new hope for effectively managing NAFLD in T2 DM patients.Bariatric surgery provides obese T2 DM patients with a powerful means to treat NAFLD.The discovery of adipokines such as adiponectin and fibroblast growth factor 21（FGF21） may point to a new research direction for NAFLD.In this paper,we present therapeutic options currently available for NAFLD in T2 DM patients as well as the present research progress in NAFLD with T2 DM,with regards to epidemiology and pathophysiologic links between them.

关 键 词：2型糖尿病 非酒精性脂肪肝病 防治 

分 类 号：R587.1[医药卫生—内分泌] R575.5[医药卫生—内科学]