Diabete e fegato - SID ItaliaDiabete e fegato. Antonino Picciotto. U.O.C. Clinica...
Transcript of Diabete e fegato - SID ItaliaDiabete e fegato. Antonino Picciotto. U.O.C. Clinica...
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Diabete e fegato
Antonino PicciottoU.O.C. Clinica Gastroenterologica
Ospedale Policlinico San Martino Genova IRCCS
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LA SINDROME METABOLICA
Diabetetipo 2 Ipertensione
Obesitàviscerale
NAFLD
Dislipidemia aterogenica>TG <HDL
NAFLD: Steatosi Epatica Non-Alcolica
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NAFLD: accumulo di trigliceridi negli epatociti a patogenesi metabolica
NAFLD: Steatosi epatica non alcolicaNASH: Steatoepatite non alcolicaHCC: Epatocarcinoma
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J Hepatol, 2019
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Younossi ZM et al, J Hepatol 2019
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Younossi ZM et al, J Hepatol 2019
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Relationship between diabetes, NAFLD and their consequences
Rhee EJ, Endocrinology and Metabolism 2019
NAFLD: Non Alcoholic Fatty Liver Disease; NASH: Non Alcoholic Steato Hepatitis
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NAFLD and T2D: Two sides of the same coin?
• T2D Increases the Risk of NAFLD progression to NASH, Cirrhosis and Hepatocellular Carcinoma
• NAFLD Increases Risks of T2D
Xia MF et al, Front Pharmacol 2019
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The pathophisiological connections between NAFLD and T2D
Xia MF et al, Frontiers in Pharmacology, 2019
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Bellan M et al, Diabetes & Metabolism Journal 2019 in press
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Lombardi R et al, Liver International 2019, 14 October
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J Hepatol, 2016
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VALUTAZIONE ECOGRAFICA
STEATOSI EPATICA
FIBROSI EPATICA
Controlled Attenuation Parameter (CAP)
STADIAZIONE STEATOSIS0-S1-S2-S3
Elastografia Transiente (Fibroscan)STADIAZIONE FIBROSI
F0-F1-F2-F3-F4
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1) There are no approved drugs for the treatment of NAFLD/NASH with or without T2D2) Glucagon-like peptide 1 receptor agonists (GLP-1) and Sodium-Glucose-Transporter-2 inhibitors
(SGLT2) may have beneficial effects on the liver (decreas liver fat, inflammation and fibrosis)
Athyros VG et al, Current Vascular Pharmacology 2019
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PDTA NAFLD/NASH