期刊
CURRENT PHARMACEUTICAL DESIGN
卷 25, 期 18, 页码 2051-2059出版社
BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/1381612825666190708192134
关键词
Obesity; metabolic syndrome; non-alcoholic fatty liver disease; diabetic retinopathy; diabetic peripheral neuropathy; diabetic kidney disease
Background: Obesity frequently co-exists with type 2 diabetes mellitus (T2DM), leading to the socalled diabesity epidemic. The metabolic syndrome (MetS), a cluster of central obesity, hypertension, dysglycemia, insulin resistance and/or atherogenic dyslipidemia, as well as non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of MetS, has been associated with increased cardiovascular disease (CVD), T2DM and chronic kidney disease (CKD) incidence. However, the association between obesity, MetS (including NAFLD) and diabetic microvascular complications is less evident. Methods: The present narrative review discusses the associations of obesity, MetS and NAFLD with diabetic kidney disease (DKD), diabetic retinopathy (DR) and diabetic peripheral neuropathy (DPN) as well as cardiac autonomic neumpathy (CAN). The available data on the effects of lifestyle measures and bariatric surgery on these diabetic complications are also briefly discussed. Results: Overall, both obesity and MetS have been related to DKD, DR and DPN, although conflicting results exist. Links between NAFLD and diabetic microvascular complications have also been reported but data are still limited. Lifestyle intervention and bariatric surgery may prevent the development and/or progression of these microvascular complications but more evidence is needed. Conclusion: Clinicians should be aware of the frequent co-existence of MetS and/or NAFLD in T2DM patients to prevent or treat these metabolic disorders, thus potentially minimizing the risk for both CVD and diabetic microvascular complications.
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