Cardiovascular Health in the Shadow of Diabetes and Metabolic Dysfunction-Associated Steatotic Liver Disease: An...

Area of Science:

• Internal Medicine
• Cardiology
• Hepatology
• Endocrinology

Background:

• Type 2 diabetes (T2D), metabolic dysfunction-associated steatotic liver disease (MASLD), and cardiovascular disease (CVD) frequently coexist, leading to accelerated vascular aging and poor prognosis.
• Insulin resistance is a common link, driving systemic inflammation, oxidative stress, and endothelial dysfunction beyond glucose metabolism.
• Gut-derived metabolites and adipose dysfunction are under-recognized contributors to this triad.

Purpose of the Study:

• To review the clinical profile of patients with coexisting T2D, MASLD, and CVD.
• To highlight challenges in current diagnostic and therapeutic approaches.
• To discuss emerging treatments and the need for integrated care.

Main Methods:

• Literature review focusing on the interplay between T2D, MASLD, and CVD.
• Analysis of shared pathophysiological mechanisms including insulin resistance, inflammation, and oxidative stress.
• Summary of current and potential therapeutic strategies, including novel agents and noninvasive tools.

Main Results:

• The triad of T2D, MASLD, and CVD presents significant clinical challenges with accelerated vascular aging.
• Shared pathways involving inflammation, oxidative stress, and endothelial dysfunction are key.
• Emerging therapies like SGLT2 inhibitors, GLP-1 receptor agonists, and tirzepatide show promise but require clinical integration.

Conclusions:

• An integrated, patient-centered approach with early screening and multidisciplinary management is essential.
• Recognizing shared pathophysiological pathways can improve complication anticipation and long-term outcomes.
• Bridging the gap between research findings and clinical practice in hepatology and cardiology is critical.