Type 2 diabetes mellitus, non-alcoholic fatty liver disease and cardiovascular disease: causal relationships and the role of anti-diabetic drugs

T. Demidova, D. Skuridina, E. S. Pervushina
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Abstract

All over the world, the number of patients suffering from type 2 diabetes mellitus, non-alcoholic fatty liver disease and cardiovascular diseases is increasing every day. At the same time, they not only coexist as independent diseases, but also have many points of intersection in pathogenesis and progression, such as dyslipidemia, prothrombotic processes, insulin resistance and hyperglycemia, chronic subclinical inflammation. Thus, they make each other’s course heavier and increase the number of adverse outcomes, including general and cardiovascular mortality. All this is an incentive for a more detailed study of the complex relationship of these diseases, in order to optimize diagnostics and treatment. Due to the urgency of this issue, the effect of most of the currently existing hypoglycemic drugs on non-alcoholic fatty liver disease and cardiovascular diseases has already been reflected in many studies and meta-analyses. This review will cover the main groups of drugs, namely biguanides, thiazolidinediones, sodium-glucose cotransporter type 2 inhibitors, dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists. The use of which is approved in comorbid patients according to these conditions pathogenesis.
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2型糖尿病、非酒精性脂肪肝和心血管疾病:因果关系及降糖药的作用
在世界范围内,患有2型糖尿病、非酒精性脂肪肝和心血管疾病的患者数量每天都在增加。同时,它们不仅作为独立的疾病共存,而且在发病和进展上也有许多交叉点,如血脂异常、血栓形成过程、胰岛素抵抗和高血糖、慢性亚临床炎症等。因此,它们使彼此的病程加重,并增加了不良后果的数量,包括一般和心血管死亡率。所有这些都促使人们对这些疾病的复杂关系进行更详细的研究,以优化诊断和治疗。由于这一问题的紧迫性,目前大多数降糖药物对非酒精性脂肪性肝病和心血管疾病的作用已经在许多研究和荟萃分析中得到反映。本综述将涵盖药物的主要类别,即双胍类药物、噻唑烷二酮类药物、钠-葡萄糖共转运蛋白2型抑制剂、二肽基肽酶-4抑制剂和胰高血糖素样肽-1受体激动剂。根据这些疾病的发病机制,批准在合并症患者中使用。
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