Non-alcoholic fatty liver disease (NAFLD) is tightly associated with the most frequent metabolic disorders, such as obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM).
Excessive lipid and later cytokine release by dysfunctional adipose tissue, intestinal dysbiosis and ectopic fat deposition in skeletal muscle lead to insulin resistance due to abnormal lipid handling and mitochondrial function. Over time, cellular oxidative stress and activation of inflammatory pathways, supported by multiorgan crosstalk, determine NAFLD progression.
Recent studies show that particularly the severe insulin resistant diabetes subgroup associates with NAFLD and its accelerated progression and increases the risk of diabetes-related cardiovascular and kidney diseases.
This review by Bedair Dewidar et al. (Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany) addresses the bidirectional relationship between mechanisms underlying T2DM and NAFLD, the relevance of novel biomarkers for improving the diagnostic modalities and the identification of subgroups at specific risk of disease progression.