Diabete e fegato

Antonino PicciottoU.O.C. Clinica Gastroenterologica

Ospedale Policlinico San Martino Genova IRCCS

LA SINDROME METABOLICA

Diabetetipo 2 Ipertensione

Obesitàviscerale

NAFLD

Dislipidemia aterogenica>TG <HDL

NAFLD: Steatosi Epatica Non-Alcolica

NAFLD: accumulo di trigliceridi negli epatociti a patogenesi metabolica

NAFLD: Steatosi epatica non alcolicaNASH: Steatoepatite non alcolicaHCC: Epatocarcinoma

J Hepatol, 2019

Younossi ZM et al, J Hepatol 2019

Younossi ZM et al, J Hepatol 2019

Relationship between diabetes, NAFLD and their consequences

Rhee EJ, Endocrinology and Metabolism 2019

NAFLD: Non Alcoholic Fatty Liver Disease; NASH: Non Alcoholic Steato Hepatitis

NAFLD and T2D: Two sides of the same coin?

• T2D Increases the Risk of NAFLD progression to NASH, Cirrhosis and Hepatocellular Carcinoma

• NAFLD Increases Risks of T2D

Xia MF et al, Front Pharmacol 2019

The pathophisiological connections between NAFLD and T2D

Xia MF et al, Frontiers in Pharmacology, 2019

Bellan M et al, Diabetes & Metabolism Journal 2019 in press

Lombardi R et al, Liver International 2019, 14 October

J Hepatol, 2016

VALUTAZIONE ECOGRAFICA

STEATOSI EPATICA

FIBROSI EPATICA

Controlled Attenuation Parameter (CAP)

STADIAZIONE STEATOSIS0-S1-S2-S3

Elastografia Transiente (Fibroscan)STADIAZIONE FIBROSI

F0-F1-F2-F3-F4

1) There are no approved drugs for the treatment of NAFLD/NASH with or without T2D2) Glucagon-like peptide 1 receptor agonists (GLP-1) and Sodium-Glucose-Transporter-2 inhibitors

(SGLT2) may have beneficial effects on the liver (decreas liver fat, inflammation and fibrosis)

Athyros VG et al, Current Vascular Pharmacology 2019

PDTA NAFLD/NASH