Nonalcoholic fatty liver disease: cause or consequence of type 2 diabetes?
Open accessAbstract
Growing epidemiological evidence suggests that nonalcoholic fatty liver disease (NAFLD) is an early predictor of and determinant for the development of type 2 diabetes and other features of the metabolic syndrome. This finding may have important clinical implications for the diagnosis, prevention and treatment of type 2 diabetes and its chronic complications. However, given the complex and bi‐directional relationships between NAFLD, insulin resistance and chronic hyperglycaemia, it is extremely difficult to distinguish whether NAFLD is a cause or a consequence of insulin resistance and type 2 diabetes. Indeed, at the molecular level, hepatic lipogenesis and hepatic glucose production depend on differentially regulated branches of the insulin signalling pathway. Furthermore, genetic studies suggest that excess hepatic fat is associated with progressive liver disease, but does not always increase the risk of incident type 2 diabetes. Here, we will briefly review the epidemiological, pathophysiological and molecular evidence linking NAFLD to the development of type 2 diabetes. We will also discuss some recent genetic and therapeutic advances that seem to challenge a causal role of NAFLD in the pathogenesis type 2 diabetes, and propose a working hypothesis to explain this apparent conundrum. In conclusion, progressive liver disease and type 2 diabetes are divergent though inter‐related consequences of insulin resistance and the metabolic syndrome.
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Epidemiological studies suggest that NAFLD may be a precursor to insulin resistance and type 2 diabetes.
“Epidemiological studies have suggested that the presence of NAFLD might be a precursor to the development of other conditions, such as insulin resistance and T2DM151.”
From Mitochondrial and metabolic dysfunction in ageing and age-related diseases (2022) · cites this paper as [151]
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- Authors
- Valenti, L., Bugianesi, E., Pajvani, U., & Targher, G.
- Affiliations
- University of Milan (IT)
- Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT)
- Columbia University Irving Medical Center (US)
- University of Verona (IT)
- Corresponding author
- Valenti, Luca
- Venue
- Liver International
- Publisher
- Wiley
- Published
- 2016-06-30
- Volume
- 36
- Issue
- 11
- Pages
- 1563-1579
- ISSN
- 0106-9543 (ISSN-L)
- 1478-3223
- 1478-3231
- OpenAlex
- W2413052899
- Cited by
- 171
- References
- 141
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 17 · 2023: 13 · 2022: 18 · 2021: 20 · 2020: 25 · 2019: 18 · 2018: 12 · 2017: 24 · 2016: 1
- FWCI
- 2.48
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Liver International (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Funders
- Associazione Italiana per la Ricerca sul Cancro (16888)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- non-alcoholic fatty liver disease, type 2 diabetes, insulin resistance, metabolic syndrome, hepatic steatosis, hepatic lipogenesis, hepatic glucose production, insulin signaling, genetic susceptibility, causal relationship, pathogenesis, chronic hyperglycemia
- MeSH terms
- Diabetes Mellitus, Type 2, Humans, Insulin, Insulin Resistance, Liver, Risk Factors, Signal Transduction, Metabolic Syndrome, Non-alcoholic Fatty Liver Disease
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