Hepatic steatosis and Type 2 diabetes: current and future treatment considerations

Abstract

Hepatic steatosis, considered the first step in the pathophysiologic continuum of non-alcoholic fatty liver disease, is estimated to afflict 30% of the US population and over 75% of patients with Type 2 diabetes. Given the expected rise in the prevalence of obesity and Type 2 diabetes in the following decades, hepatic steatosis will, if not already, become an epidemic. The consequences of hepatic steatosis are numerous, and range from progression to chronic liver disease, with its associated morbidity and mortality, to worsening insulin resistance and Type 2 diabetes, as well as being an independent contributor to cardiovascular disease. All such consequences are more likely to occur in patients with Type 2 diabetes who are already at high risk of cardiovascular events. In this article we review the evidence behind the available therapeutic options for hepatic steatosis, and identify challenges and unmet needs in the field.

Keywords::

• FXR agonists
• hepatic steatosis
• incretin mimetics
• metabolic syndrome
• metformin
• non-alcoholic fatty liver disease
• obesity
• thiazolidinediones
• Type 2 diabetes

Financial & competing interests disclosure

Ildiko Lingvay’s research is supported by the NIH (grant no. 1K23RR024470). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.