The gut-liver axis: emerging mechanisms and therapeutic approaches for nonalcoholic fatty liver disease and type 2 diabetes mellitus

Nonalcoholic fatty liver disease (NAFLD), more appropriately known as metabolic (dysfunction) associated fatty liver disease (MAFLD), a prevalent condition in type 2 diabetes mellitus (T2DM) patients, is a complex condition involving hepatic lipid accumulation, inflammation, and liver fibrosis. The...

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Bibliographic Details
Published in:Naunyn-Schmiedeberg's archives of pharmacology 2024-11, Vol.397 (11), p.8421-8443
Main Authors: Bhardwaj, Monika, Mazumder, Papiya Mitra
Format: Article
Language:English
Subjects:
Biomedical and Life Sciences
Biomedicine
Cardiovascular diseases
Diabetes
Diabetes mellitus (non-insulin dependent)
Dysbacteriosis
Fatty liver
Fibrosis
Inflammation
Insulin resistance
Intestinal microflora
Liver diseases
Metabolism
Metabolites
Microbiota
Molecular modelling
Neurosciences
Obesity
Oxidative stress
Pharmacology/Toxicology
Review
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Summary:Nonalcoholic fatty liver disease (NAFLD), more appropriately known as metabolic (dysfunction) associated fatty liver disease (MAFLD), a prevalent condition in type 2 diabetes mellitus (T2DM) patients, is a complex condition involving hepatic lipid accumulation, inflammation, and liver fibrosis. The gut-liver axis is closely linked to metabolic dysfunction, insulin resistance, inflammation, and oxidative stress that are leading to the cooccurrence of MAFLD and T2DM cardiovascular diseases (CVDs). The purpose of this review is to raise awareness about the role of the gut-liver axis in the progression of MAFLD, T2DM and CVDs with a critical analysis of available treatment options for T2DM and MAFLD and their impact on cardiovascular health. This study analysed over 100 articles on this topic, using online searches and predefined keywords, to understand and summarise published research. Numerous studies have shown a strong correlation between gut dysfunction, particularly the gut microbiota and its metabolites, and the occurrence and progression of MAFLD and type 2 diabetes mellitus (T2DM). Herein, this article also examines the impact of the gut-liver axis on MAFLD, T2DM, and related complications, focusing on the role of gut microbiota dysbiosis in insulin resistance, T2DM and obesity-related cardiovascular complications. The study suggests potential treatment targets for MAFLD linked to T2DM, focusing on cardiovascular outcomes and the molecular mechanism of the gut-liver axis, as gut microbiota dysbiosis contributes to obesity-related metabolic abnormalities.
ISSN:0028-1298
1432-1912
1432-1912
DOI:10.1007/s00210-024-03204-6