David Britez*, Craig Venter
Metabolic-Associated Fatty Liver Disease (MAFLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is a condition characterized by the accumulation of fat in the liver. It is strongly associated with metabolic syndrome, which includes obesity, insulin resistance, dyslipidemia, and hypertension. MAFLD has emerged as the most common cause of chronic liver disease worldwide.
The relationship between MAFLD and diabetes is bidirectional and complex. Diabetes is a well-established risk factor for the development and progression of MAFLD. Insulin resistance, a hallmark of type 2 diabetes, plays a crucial role in the pathogenesis of MAFLD. When cells become resistant to the effects of insulin, the pancreas compensates by producing more insulin. This excess insulin promotes lipid accumulation in the liver, leading to the development of MAFLD.
On the other hand, MAFLD itself can contribute to the development of diabetes. The excessive accumulation of fat in the liver leads to the release of pro-inflammatory cytokines and adipokine, which can impair insulin signaling and promote systemic inflammation. This chronic low-grade inflammation contributes to the development of insulin resistance and ultimately increases the risk of developing type 2 diabetes.
Furthermore, MAFLD is associated with other metabolic abnormalities that can contribute to the development of diabetes. These include dyslipidemia, increased visceral fat deposition, and altered gut microbiota composition, all of which are implicated in the pathogenesis of insulin resistance and impaired glucose metabolism.
The presence of MAFLD in individuals with diabetes is also associated with worse glycemic control and an increased risk of diabetic complications. MAFLD can exacerbate insulin resistance, making it more challenging to manage blood sugar levels. It is also associated with a higher prevalence of cardiovascular disease, which is a common complication of both MAFLD and diabetes.
Given the bidirectional relationship between MAFLD and diabetes, the management of these conditions often involves addressing both simultaneously. Lifestyle modifications, including weight loss, regular physical activity, and a healthy diet, are cornerstones of therapy. Pharmacological interventions, such as medications for diabetes and nonalcoholic steatohepatitis (NASH), may also be considered depending on the severity of the conditions.
KeywordsMedication; Diabetes; Abnormalities; Liver disease
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