代谢相关脂肪性肝病与2型糖尿病共同管理研究进展

doi:10.12114/j.issn.1007-9572.2024.0591

中国全科医学 ›› 2025, Vol. 28 ›› Issue (23): 2846-2851.DOI: 10.12114/j.issn.1007-9572.2024.0591

所属专题：内分泌代谢性疾病最新文章合辑

• 论著·慢性病共病专题·糖肝共管 • 上一篇下一篇

代谢相关脂肪性肝病与2型糖尿病共同管理研究进展

王鹏¹, 仇丽霞¹, 许姗姗¹, 张洋², 张晶¹, 杜晓菲¹^,^*()

1．100069　北京市，首都医科大学附属北京佑安医院肝病中心三科
2．100069　北京市肝病研究所

收稿日期:2024-11-27 修回日期:2024-12-25 出版日期:2025-08-15 发布日期:2025-06-17
通讯作者: 杜晓菲
王鹏和仇丽霞为共同第一作者

作者贡献：
王鹏负责文章的构思和设计、资料的收集，文章的撰写；仇丽霞负责文献的整理，共同参与文章撰写；许姗姗和张洋负责文献的查阅整理；张晶共同参与论文的修订和质量控制；杜晓菲负责论文的修订，文章的质量控制及审校、对文章整理负责，监督管理。
基金资助:
国家科技重大专项资助项目(2023ZD0508703); 北京市高层次公共卫生技术人才建设项目(03-23); 首都卫生发展科研专项资助项目(2024-1-4081，2024-2-1151)

Advances in the Co-management of Metabolism Dysfunction-associated Fatty Liver Disease and Type 2 Diabetes Mellitus

WANG Peng¹, QIU Lixia¹, XU Shanshan¹, ZHANG Yang², ZHANG Jing¹, DU Xiaofei¹^,^*()

1. The Third Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
2. Beijing Institute of Liver Diseases, Beijing 100069, China

Received:2024-11-27 Revised:2024-12-25 Published:2025-08-15 Online:2025-06-17
Contact: DU Xiaofei
About author:
WANG Peng and QIU Lixia are co-first authors

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摘要/Abstract

摘要： 代谢相关脂肪性肝病（MAFLD）和2型糖尿病（T2DM）是全球常见的两大代谢性疾病，目前二者共病存在较高的流行率，同时能加速疾病的进展，给患者带来严重的疾病负担，是当前面临的重大公共卫生问题。MAFLD和T2DM相互影响，有着共同的发病机制。制定有效的MAFLD和T2DM共同管理策略是临床亟待解决的重要问题。本文围绕T2DM合并MAFLD的流行病学、发病机制、筛查监测、治疗等方面的最新进展进行详细阐述。本综述表明T2DM合并MAFLD为已成为临床的普遍现象，二者可互相影响，促进疾病的发生、发展。在T2DM患者中应开展MAFLD的筛查，无创诊断模型如纤维化指数4、脂肪肝纤维化评分等多种模型可用于常规筛查，但准确性有待进一步验证。此外，钠-葡萄糖共转运体2抑制剂、胰高血糖素样肽1受体激动剂等新型药物被证实可用于治疗T2DM合并MAFLD，同时能有效改善疾病的预后及预防心血管事件等。本文为T2DM合并MAFLD的临床诊疗策略的优化以及临床"糖肝共管"策略的制定提供了参考依据。

Abstract:

Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM) are the two most common metabolic diseases worldwide. The coexistence of MAFLD and T2DM has a high prevalence rate and accelerates disease progression, imposing a significant disease burden on patients and posing a major public health challenge. MAFLD and T2DM mutually influence each other, sharing common pathogenic mechanisms. Developing effective co-management strategies for MAFLD and T2DM is a critical clinical priority. This review elaborates on recent advances in the epidemiology, pathogenesis, screening, monitoring, and treatment of T2DM combined with MAFLD. It highlights that the co-existence of T2DM and MAFLD has become a common clinical phenomenon with each condition exacerbating the development and progression of the other. Screening for MAFLD should be implemented in T2DM patients. Non-invasive diagnostic tools such as the Fibrosis 4 Index and NAFLD Fbrosis Score can be used for routine screening, though their accuracy requires further validation. Additionally, medications like sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists have been shown to improve outcomes in patients with T2DM and MAFLD, effectively preventing cardiovascular events. This review provides reference for the optimization of clinical diagnosis and treatment strategy of T2DM combined with MAFLD and the formulation of clinical "glycohepatic co-management" strategy.

Key words: Metabolic dysfunction-associated fatty liver disease, Type 2 diabetes mellitus, Co-management of MAFLD and T2DM, Metabolic diseases, Chronic liver disease

中图分类号:

R 575.5　R587.1

王鹏,仇丽霞,许姗姗,等. 代谢相关脂肪性肝病与2型糖尿病共同管理研究进展[J]. 中国全科医学, 2025, 28(23): 2846-2851. DOI: 10.12114/j.issn.1007-9572.2024.0591.
WANG Peng,QIU Lixia,XU Shanshan, et al. Advances in the Co-management of Metabolism Dysfunction-associated Fatty Liver Disease and Type 2 Diabetes Mellitus[J]. Chinese General Practice, 2025, 28(23): 2846-2851. DOI: 10.12114/j.issn.1007-9572.2024.0591.

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代谢相关脂肪性肝病与2型糖尿病共同管理研究进展

Advances in the Co-management of Metabolism Dysfunction-associated Fatty Liver Disease and Type 2 Diabetes Mellitus

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