Naslov
Post-transplant diabetes mellitus and preexisting liver disease - a bidirectional relationship affecting treatment and management
(Post-transplant diabetes mellitus and preexisting liver disease - a bidirectional relationship affecting treatment and management)

Autori
Cigrovski Berković, Maja ; Virović-Jukić, Lucija ; Bilić-Ćurčić, Ines ; Mrzljak, Anna

Izvornik
World journal of gastroenterology (1007-9327) 26 (2020), 21; 2740-2757

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pregledni rad, znanstveni

Ključne riječi
diabetes mellitus ; liver transplantation ; non-alcoholic fatty liver disease ; metabolic syndrome ; insulin-resistance ; glucagon-like peptide-1 receptor agonists ; sodium-glucose cotransporter 2 inhibitors

Sažetak
Liver cirrhosis and diabetes mellitus (DM) are both common conditions with significant socioeconomic burden and impact on morbidity and mortality. A bidirectional relationship exists between DM and liver cirrhosis regarding both etiology and disease-related complications. Type 2 DM (T2DM) is a well recognized risk factor for chronic liver disease and vice-versa, DM may develop as a complication of cirrhosis, irrespective of its etiology. Liver transplantation (LT) represents an important treatment option for patients with end-stage liver disease due to non- alcoholic fatty liver disease (NAFLD), which represents a hepatic manifestation of metabolic syndrome and a common complication of T2DM. The metabolic risk factors including immunosuppressive drugs, can contribute to persistent or de novo development of DM and NAFLD after LT. T2DM, obesity, cardiovascular morbidities and renal impairment, frequently associated with metabolic syndrome and NAFLD, may have negative impact on short and long-term outcomes following LT. The treatment of DM in the context of chronic liver disease and post- transplant is challenging, but new emerging therapies such as glucagon-like peptide-1 receptor agonists (GLP- 1RAs) and sodium–glucose cotransporter 2 inhibitors (SGLT2i) targeting multiple mechanisms in the shared pathophysiology of disorders such as oxidative stress and chronic inflammation are a promising tool in future patient management.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

POVEZANOST RADA