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改善非酒精性脂肪性肝病可以逆转2型糖尿病吗?
Can type 2 diabetes mellitus be reversed by improving nonalcoholic fatty liver disease?
文章发布日期:2020年06月01日  来源:  作者:颜红梅  点击次数:233次  下载次数:86次

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【摘要】:摘要:非酒精性脂肪性肝病(NAFLD)使非糖尿病患者新发2型糖尿病(T2DM)风险增加2~3倍,因此,NAFLD 人群是一个庞大的T2DM高危人群。在已诊断T2DM人群中,NAFLD患病率高达60%~80%。传统观点认为T2DM是一个终身性疾病,然而近期较多证据支持T2DM是可以缓解的疾病,为T2DM的防治带来了新的曙光。T2DM的缓解取决于合适的治疗手段及时机,肝脏在糖脂代谢中发挥了关键作用,肝脏过多脂肪积聚可引起胰岛素抵抗、肝葡萄糖和甘油三酯输出增多,进而引起胰腺的脂质沉积导致β细胞受损,最终发展为T2DM。生活方式干预治疗在降低肝脂肪含量的同时,可带来糖尿病的缓解或者逆转,NAFLD可作为T2DM的“预警窗口”。因此,以降低肝脂肪含量为目标的治疗方案有望成为预防和逆转糖尿病的良策。
【Abstract】:Nonalcoholic fatty liver disease (NAFLD) is associated with a 2- to 3-fold increase in the risk of developing type 2 diabetes (T2DM) in non-diabetic patients, and therefore, the NAFLD population is considered a large population at a high risk of T2DM. In the population diagnosed with T2DM, the prevalence rate of NAFLD reaches as high as 60%-80%. T2DM is considered a lifelong disease in the traditional view, but recently, more and more evidence supports that T2DM can be reversed, which brings new light to the prevention and treatment of T2DM. The remission of T2DM depends on the appropriate treatment methods and timing. The liver plays a key role in glucose and lipid metabolism, and excessive fat accumulation in the liver may induce insulin resistance, increased production of hepatic glucose, and increased triglyceride export, which further leads to fat deposition in the pancreas and beta-cell injury and eventually causes the onset of T2DM. Lifestyle intervention can reduce liver fat content and achieve the remission or reversal of diabetes, and NAFLD can be regarded as an “early warning window” for T2DM. Therefore, the treatment regimen aiming at improving liver fat content may become a good strategy to prevent and reverse diabetes.
【关键字】:非酒精性脂肪性肝病; 糖尿病,2型; 治疗学
【Key words】:non-alcoholic fatty liver disease; diabetes mellitus,type 2; therapeutics
【引证本文】:YAN HM. Can type 2 diabetes mellitus be reversed by improving nonalcoholic fatty liver disease?[J]. J Clin Hepatol, 2020, 36(6): 1213-1216. (in Chinese)
颜红梅. 改善非酒精性脂肪性肝病可以逆转2型糖尿病吗?[J]. 临床肝胆病杂志, 2020, 36(6): 1213-1216.

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