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Review
. 2021 Mar 19;21(5):15.
doi: 10.1007/s11892-021-01383-7.

The Relationship Between Type 2 Diabetes, NAFLD, and Cardiovascular Risk

Cyrielle Caussy  1 , Adrien Aubin  2 , Rohit Loomba  3   4   5
Affiliations
Review

The Relationship Between Type 2 Diabetes, NAFLD, and Cardiovascular Risk

Cyrielle Caussy et al. Curr Diab Rep. .

Abstract

Purpose of review: Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are strongly associated. Both also associate with an increased risk of cardiovascular disease (CVD).

Recent findings: Several studies have provided evidence that NAFLD could be an independent CVD risk factor. Given the strong association between NAFLD and T2DM, assessing the independent CV effect of these two conditions remains challenging. However, patients with T2DM and NAFLD exhibit higher risk of CVD compared with T2DM without NAFLD suggesting a potential synergistic increase of CV risk in patients with both T2DM and NAFLD supported by several shared pathophysiological pathways. Several anti-diabetic therapies have shown beneficial effect on both NAFLD and CVD. Patients with T2DM and NAFLD should be considered at high risk of CVD and could benefit from more intensive CV prevention. Additional long-term follow-up is needed to demonstrate that the treatment of NAFLD effectively reduces the risk of CVD.

Keywords: Cardiovascular disease; Cirrhosis; Fibrosis; Insulin resistance; Metabolic syndrome; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Type 2 diabetes.

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Figures

Fig. 1
Fig. 1
Potential pathophysiological mechanisms linking NAFLD, T2DM, and CVD. Several shared pathophysiological pathways link NAFLD and T2DM to an increased cardiovascular risk including pro-atherogenic lipid alteration, increase in thrombosis factors, insulin resistance, low-grade inflammation, and microbiome alteration. Abbreviations: CRP: C-reactive protein, IL: interleukin, LPS: lipopolysaccharide, PAI-1: plasminogen activator inhibitor type 1, SCFA: short chain fatty acids, sdLDL: small dense low-densitylipoprotein, TMAO: trimethylamine N-oxide, TNF-α: tumor necrosis factor-α, VLDL: very low density lipoprotein
See this image and copyright information in PMC

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