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Area of Science:

  • Hepatology
  • Endocrinology
  • Gastroenterology

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing health concern.
  • Non-alcoholic steatohepatitis (MASH) represents the progressive, inflammatory stage of MASLD.
  • MASH frequently coexists with type 2 diabetes (T2D), leading to poorer liver and cardiovascular outcomes.

Purpose of the Study:

  • To review the complex interplay between T2D and MASH.
  • To explore the underlying mechanisms driving disease progression.
  • To discuss potential therapeutic strategies for T2D-related MASH.

Main Methods:

  • Literature review focusing on the synergistic effects of metabolic alterations.
  • Analysis of pathways involving adipose tissue, gut microbiota, and hepatic changes.
  • Examination of current and emerging therapeutic interventions.

Main Results:

  • Adipose tissue dysfunction and gut dysbiosis exacerbate hepatic injury and insulin resistance.
  • Hepatic lipid accumulation, oxidative stress, and ER stress contribute to inflammation and fibrosis.
  • Lifestyle modifications (diet, exercise) are crucial for managing T2D-related MASH.

Conclusions:

  • Therapeutic strategies for T2D-related MASH should address the interconnectedness of metabolic factors.
  • Anti-hyperglycemic medications, particularly those targeting incretin receptors, show promise.
  • Thyroid hormone receptor-β agonism is an effective treatment for MASH and associated fibrosis.