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Diabetes Care：管理2型糖尿病患者合并非酒精性脂肪肝的行动呼吁

2017-02-25 MedSci MedSci原创

糖尿病酒精性脂肪肝管理
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非酒精性脂肪肝（NAFLD）近来已成为卫生保健者主要关注的肝脏疾病之一。近年，2型糖尿病（T2DM）患者的发展也使得NAFLD的病变过程恶化，合并肝脏疾病使得对糖尿病患者的管理更具挑战性。然而，这两种疾病相互关系的性质至今仍未完全了解。虽然NAFLD的流行率增加常常归因于肥胖症的流行，并且经常被过度简化为“代谢综合征的肝脏表现”。但实际上它是更复杂的疾病过程，它可以在非肥胖症个体和没有临床表现的患

非酒精性脂肪肝（NAFLD）近来已成为卫生保健者主要关注的肝脏疾病之一。近年，2型糖尿病（T2DM）患者的发展也使得NAFLD的病变过程恶化，合并肝脏疾病使得对糖尿病患者的管理更具挑战性。

然而，这两种疾病相互关系的性质至今仍未完全了解。虽然NAFLD的流行率增加常常归因于肥胖症的流行，并且经常被过度简化为“代谢综合征的肝脏表现”。但实际上它是更复杂的疾病过程，它可以在非肥胖症个体和没有临床表现的患者中出现代谢综合征的表现。它具有代谢性和肝特异性并发症状，使其在医疗过程中具有一定的独特性。

糖尿病似乎可以促进非酒精性脂肪性肝炎（NASH）的发展，非酒精性脂肪性肝炎（NASH）是该疾病的更严重形式，并且增加了肝硬化和肝细胞癌的风险。

患者和医生面临许多不确定性，包括疾病的自然病程相关信息、对NASH的诊断以及寻求有效药物的挑战。

近期，对该疾病的诊断和治疗方面取得一定进展，如若对该疾病不作处理可能会发生严重后果，要求医疗保健者在管理T2DM和NASH的患者中应更加积极主动。

原始出处：
Bril F, Cusi K. Management of Nonalcoholic Fatty Liver Disease in Patients With Type 2 Diabetes: A Call to Action. Diabetes Care. 2017 Mar;40(3):419-430. doi: 10.2337/dc16-1787.

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    2017-10-09 ms5439512287675881

    #BET#

    0

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    2017-04-25 huiwelcome

    #酒精性#

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    2017-07-12 木头人513

    #Diabetes#

    0

  4. 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00:02:40 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177901, encodeId=40ee1e79015a, content=谢谢?分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Sun Feb 26 00:20:37 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
    2017-11-12 ms9608593228839890

    #DIA#

    0

  5. 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00:02:40 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177901, encodeId=40ee1e79015a, content=谢谢?分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Sun Feb 26 00:20:37 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
    2017-10-21 yangshch

    #酒精性脂肪肝#

    0

  6. 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00:02:40 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177901, encodeId=40ee1e79015a, content=谢谢?分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Sun Feb 26 00:20:37 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
    2017-03-14 Tommy1958

    #非酒精性#

    0

  7. 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00:02:40 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177901, encodeId=40ee1e79015a, content=谢谢?分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Sun Feb 26 00:20:37 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
    2017-02-27 aids213

    #2型糖尿病患者#

    0

  8. 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00:02:40 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177901, encodeId=40ee1e79015a, content=谢谢?分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Sun Feb 26 00:20:37 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
    2017-02-27 xue8604

    #糖尿病患者#

    0

  9. 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00:02:40 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177901, encodeId=40ee1e79015a, content=谢谢?分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Sun Feb 26 00:20:37 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
    2017-02-27 1e0ece0dm09(暂无匿称)

    谢谢指点迷津

    0

  10. 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00:02:40 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177901, encodeId=40ee1e79015a, content=谢谢?分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Sun Feb 26 00:20:37 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
    2017-02-26 1e0ece0dm09(暂无匿称)

    谢谢?分享

    0

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胰腺癌：“你可能得了假的糖尿病……”

刚结束的欧洲癌症大会公布了一项惊人的研究，糖尿病不仅会导致胰腺癌，它可能就是胰腺癌的早期表现。

Diabetes Care：糖化血红蛋白和老年糖尿病和非糖尿病患者死亡率有啥关系？

由此可见，HbA1c＞8%与老年糖尿病患者全因死亡率和病因特异性死亡率风险增加相关。该研究结果支持更好的控制血糖对于降低死亡率很重要这一观点；然而，在相互矛盾的证据基础上，对于老年人糖尿病患者也需要有一个个性化的血糖控制目标，其取决于患者的人口学特征、糖尿病病程和现有的合并症。

1分钟趣说—血糖与糖尿病

身为糖医，临床上极为重要的一件事，就是向患者解释病情，如何把复杂晦涩的医学内容深入浅出的解释给患者？需要的不仅仅是深厚的学术功底，还需要灵活巧妙的科普转化能力。比如，关于血糖与糖尿病，可以这么讲，只需要1分钟，几句话……什么是血糖——2句话说明白血糖，通常指的是血液中的游离葡萄糖。健康人在正常情况下，血糖在空腹和饱腹的情况下都能维持在相对恒定的范围内。正常人的空腹血糖小于6.1mmol/L，餐后两

Nature：大鼠体内培养小鼠胰腺，一劳永逸治疗小鼠糖尿病

科学家们通过给小鼠进行胰腺组织移植，成功治疗了小鼠的Ⅰ型糖尿病。这些移植的胰腺组织是由取自健康小鼠的干细胞在大鼠体内培养而成。它们在没有任何其他药物协助的情况下，成功地控制了小鼠的血糖水平长达一年以上。这同时也意味着，有糖尿病的小鼠在不需要免疫抑制药物的情况下成功地接受了胰腺组织移植。

新化合物有望同时治疗2型糖尿病和结肠癌

巴斯大学的科学家已经创造出有朝一日能够治疗癌症和糖尿病的新型药物分子。

逆转糖尿病？FMD 节食能帮你做到

来自南加州大学（USC）一个新研究显示，周期性采取模拟禁食效应的新型节食方案可以通过重编程细胞来逆转糖尿病。这种饮食被称为仿斋戒节食方案（FMD，Fasting-mimicking diet ）。