代谢相关脂肪性肝病合并2型糖尿病的流行病学、机制与治疗进展OA

Metabolic dysfunction-associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM)are closely linked in terms of epidemiology and pathophysiological mechanisms,and their comorbidi-ty has become a major global public health challenge.This review systematically summarized the epidemiolog-ical characteristics,core pathophysiological mechanisms,and comprehensive management strategies for the co-morbidity of MAFLD and T2DM.Global data show that the comorbid prevalence of T2DM in patients with MAFLD has risen to 34.1%,while the prevalence of MAFLD in patients with T2DM has reached 68.8%,and these rates continue to increase.The comorbidity significantly increases the risks of liver fibrosis,hepatocellu-lar carcinoma,and cardiovascular events,leading to elevated all-cause mortality.The core mechanisms revolve around insulin resistance and involve multiple factors,including lipid metabolism disorders,chronic inflamma-tion and oxidative stress,gut microbiota dysbiosis,and genetic susceptibility,forming a complex pathogenic network.In terms of treatment,lifestyle intervention serves as the foundation.Glucose-lowering agents such as glucagon-like peptide-1 receptor agonists,pioglitazone,and sodium-glucose cotransporter-2 inhibitors have demonstrated dual benefits.Statins and vitamin E also possess important potential dual-effect therapeutic val-ue.Bariatric surgery is applicable to selected obese patients.This review provided a reference for an in-depth understanding of the complexity of MAFLD complicated with T2DM and for the development of comprehen-sive prevention and treatment strategies.