Diabetes mellitus and liver: Non-obvious aspects
https://doi.org/10.62751/2713-0177-2025-6-3-05
Abstract
Liver damage can occur in diabetes mellitus, not only type 1 (T1DM), but also type 2 (T2DM). It can be confidently stated that there is a mutual pathogenetic relationship between T2DM and metabolic-associated fatty liver disease (MAFLD). MAFLD acts as an independent pathogenetic factor in the progression of cardiovascular, renal, and oncological diseases. Three variants of liver pathology have been described in patients with T1DM: MAFLD, glycogen hepatopathy, and diabetic hepatosclerosis, while the latter two may be pathognomonic for this type of diabetes. The representation of practitioners about the options for liver damage in diabetes makes it possible to effectively control risk factors and avoid prescribing unjustified studies and ineffective medications.
About the Authors
A. O. Bueverov
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Alexey O. Bueverov – D. Sci (Med), Professor, Leading Researcher at the Department of Hepatology, Professor of the course “Hepatology”
Moscow
E. L. Bueverova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Elena L. Bueverova – C. Sci (Med), Associate Professor of the Department of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
Moscow
References
1. Буеверов А.О. Хронические заболевания печени. Краткое руководство для практикующих врачей. 2-е издание, исправленное и дополненное. С.-Пб: ООО «Издательство МедЛит» 2025; 160 с.
2. Gofton C, Upendran Y, Zheng MH, George J. MAFLD: How is it diff ent from NAFLD? Clin Mol Hepatol. 2023;29(Suppl):S17–S31. doi: 10.3350/cmh.2022.0367.
3. Sangro P, de la Torre Alaez M, Sangro B, D'Avola D. Metabolic dysfunctionassociated fatty liver disease (MAFLD): An update of the recent advances in pharmacological treatment. J Physiol Biochem. 2023;79(4):869–79. doi: 10.1007/s13105-023-00954-4.
4. Manikat R, Ahmed A, Kim D. Current epidemiology of chronic liver disease. Gastroenterol Rep (Oxf). 2024;12:goae069. doi: 10.1093/gastro/goae069.
5. Stefan N, Sun Q, Fritsche A, Machann J, Schick F, Gerst F et al. Impact of the adipokine adiponectin and the hepatokine fetuin-A on the development of type 2 diabetes: Prospective cohortand cross-sectional phenotyping studies. PLoS One. 2014;9(3):e92238. doi: 10.1371/journal.pone.0092238
6. Rohm TV, Meier DT, Olefsky JM, Donath MY. Inflammation in obesity, diabetes, and related disorders. Immunity. 2022;55(1):31–55. doi: 10.1016/j.immuni.2021.12.013.
7. Ribeiro A, Igual-Perez MJ, Santos Silva E, Sokal EM. Childhood fructoholism and fructoholic liver disease. Hepatol Commun. 2018;3(1):44–51. doi: 10.1002/hep4.1291.
8. Herrera-Ojeda JL, Blanco-Palma RS, Chavez-Tapia NC, Uribe M, Montalvo-Jave EE, Nuno-Lambarri N. The pathophysiological link between type 1 diabetes and MASLD: Insights into insulin resistance and liver dysfunction. J Endocrinol Invest. 2025. Online ahead of print. doi: 10.1007/s40618-025-02621-5.
9. Li H, Hou Y, Xin W, Ding L, Yang Y, Zhang Y et al. The efficacy of sodium-glucose transporter 2 inhibitors in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis. Pharmacol Res. 2025;213:107647. doi: 10.1016/j.phrs.2025.107647.
10. Буеверов А.О., Зилов А.В. Поражение печени при сахарном диабете 1-го типа. Российский журнал гастроэнтерологии, гепатологии и колопроктологии. 2021;31(2):7–13. doi: 10.22416/1382-4376-2021-31-2-7-13.
11. Stadler M, Bollow E, Fritsch M, Kerner W, Schuetz-Fuhrmann I, Krakow D et al.; DPV Initiative and the German BMBF Competence Network Diabetes mellitus. Prevalence of elevated liver enzymes in adults with type 1 diabetes: A multicentre analysis of the German/Austrian DPV database. Diabetes Obes Metab. 2017;19(8):1171–78. doi: 10.1111/dom.12929.
12. de Vries M, Westerink J, Kaasjager KHAH, de Valk HW. Prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with type 1 diabetes mellitus: A systematic review and meta-analysis. J Clin Endocrinol Metab. 2020;105(12):3842–53. doi: 10.1210/clinem/dgaa575.
13. Regnell SE, Lernmark A. Hepatic steatosis in type 1 diabetes. Rev Diabet Stud. 2011;8(4):454–67. doi: 10.1900/RDS.2011.8.454.
14. Cusi K, Sanyal AJ, Zhang S, Hartman ML, Bue-Valleskey JM, Hoogwerf BJ, Haupt A. Non-alcoholic fatty liver disease (NAFLD) prevalence and its metabolic associations in patients with type 1 diabetes and type 2 diabetes. Diabetes Obes Metab. 2017;19(11):1630–34. doi: 10.1111/dom.12973.
15. Al-Hussaini AA, Sulaiman NM, Al-Zahrani M, Alenazi A. Prevalence of liver disease among type 1 diabetic children. BMC Gastroenterology. 2012;42(3):641–49.
16. Mertens J, De Block C, Spinhoven M, Driessen A, Francque SM, Kwanten WJ. Hepatopathy associated with type 1 diabetes: Distinguishing non-alcoholic fatty liver disease from glycogenic hepatopathy. Front Pharmacol. 2021;12:768576. doi: 10.3389/fphar.2021.768576.
17. Gaiani S, Avogaro A, Bombonato GC, Bolognesi M, Amor F, Vigili de Kreutzenberg S et al. Nonalcoholic fatty liver disease (NAFLD) in nonobese patients with diabetes: Prevalence and relationships with hemodynamic alterations detected with Doppler sonography. J Ultrasound. 2009;12(1):1–5. doi: 10.1016/j.jus.2008.12.002.
18. Targher G, Bertolini L, Padovani R, Rodella S, Zoppini G, Pichiri I et al. Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes. J Hepatol. 2010;53(4):713–18. doi: 10.1016/j.jhep.2010.04.030.
19. Targher G, Pichiri I, Zoppini G, Trombetta M, Bonora E. Increased prevalence of chronic kidney disease in patients with type 1 diabetes and non-alcoholic fatty liver. Diabet Med. 2012;29(2):220–26. doi: 10.1111/j.1464-5491.2011.03427.x.
20. Petit JM, Pedro L, Guiu B, Duvillard L, Bouillet B, Jooste V et al. Type 1 diabetes is not associated with an increased prevalence of hepatic steatosis. Diabet Med. 2015;32(12):1648–51. doi: 10.1111/dme.12805.
21. Tilg H, Moschen AR, Roden M. NAFLD and diabetes mellitus. Nat Rev Gastroenterol Hepatol. 2017;14(1):32–42. doi: 10.1038/nrgastro.2016.147.
22. Wong VW, Chan RS, Wong GL, Cheung BH, Chu WC, Yeung DK et al. Community-based lifestyle modification programme for non-alcoholic fatty liver disease: A randomized controlled trial. J Hepatol 2013;59(3):536–42. doi: 10.1016/j.jhep.2013.04.013.
23. Rashid M, Roberts EA. Nonalcoholic steatohepatitis in children. J Pediatr Gastroenterol Nutr. 2000;30(1):48–53. doi: 10.1097/00005176-200001000-00017.
24. Khoury J, Zohar Y, Shehadeh N, Saadi T. Glycogenic hepatopathy. Hepatobiliary Pancreat Dis Int. 2018;17(2):113–18. doi: 10.1016/j.hbpd.2018.02.006.
25. Elzubeir A, Alam S, Sington J. Image of the month: Mauriac variant: A rare complication of poorly controlled diabetes. Clin Med (Lond). 2021;21(1):76–77. doi: 10.7861/clinmed.2020-0826.
26. [Mauriac P. Grosventre, hepatomegalie, troble de la croissance chez les enfants diabetiques: traits depuis plusieursannesparl’insuline. Gaz Hebl Sci Med Bordeaux. 1930;26:402–410 (In French)].
27. Giordano S, Martocchia A, Toussan L, Stefanelli M, Pastore F, Devito A et al. Diagnosis of hepatic glycogenosis in poorly controlled type 1 diabetes mellitus. World J Diabetes. 2014;5(6):882–88. doi: 10.4239/wjd.v5.i6.882.
28. Murata F, Horie I, Ando T, Isomoto E, Hayashi H, Akazawa S et al. A case of glycogenic hepatopathy developed in a patient with new-onset fulminant type 1 diabetes: The role of image modalities in diagnosing hepatic glycogen deposition including gradient-dual-echo MRI. Endocr J. 2012;59(8):669–76. doi: 10.1507/endocrj.ej12-0081.
29. Irani NR, Venugopal K, Kontorinis N, Lee M, Sinniah R, Bates TR. Glycogenic hepatopathy is an under-recognised cause of hepatomegaly and elevated liver transaminases in type 1 diabetes mellitus. Intern Med J. 2015;45(7):777–779. doi: 10.1111/imj.12807.
30. Julian MT, Alonso N, Ojanguren I, Pizarro E, Ballestar E, Puig-Domingo M. Hepatic glycogenosis: An underdiagnosed complication of diabetes mellitus? World J Diabetes. 2015;6(2):321–25. doi: 10.4239/wjd.v6.i2.321.
31. Imtiaz KE, Healy C, Sharif S, Drake I, Awan F, Riley J, Karlson F. Glycogenic hepatopathy in type 1 diabetes: An underrecognized condition. Diabetes Care. 2013;36(1):e6–7. doi: 10.2337/dc12-1134.
32. Chen G, Brunt EM. Diabetic hepatosclerosis: A 10-year autopsy series. Liver Int. 2009;29(7):1044–50. doi: 10.1111/j.1478-3231.2008.01956.x.
33. King RJ, Harrison L, Gilbey SG, Santhakumar A, Wyatt J, Jones R, Bodansky HJ. Diabetic hepatosclerosis: another diabetes microvascular complication? Diabet Med. 2016;33(2):e5–e7. doi: 10.1111/dme.12898.
34. Hamed AE, Elwan N, Naguib M, Elwakil R, Esmat G, El Kassas M et al. Diabetes association with liver diseases: An overview for clinicians. Endocr Metab Immune Disord Drug Targets. 2019;19(3):274–80. doi: 10.2174/1871530318666181116111945.
Review
For citations:
Bueverov A.O., Bueverova E.L. Diabetes mellitus and liver: Non-obvious aspects. FOCUS. Endocrinology. 2025;6(3):41-46. (In Russ.) https://doi.org/10.62751/2713-0177-2025-6-3-05
Views:
135
Email this article 