Photo Credit: Sinhyu

Among patients with MASH and Type 2 diabetes (T2D), MASH progression is accelerated by adipose tissue and muscle insulin resistance that increases lipid influx and de novo lipogenesis in the liver, according to findings published in Diabetes Research and Clinical Practice. Laurent Castera, MD, PhD, and colleagues examined the multifaceted pathways between MASH and T2D and related therapeutic implications. The review showed that the increase in visceral adipose tissue and a changing gut microbiota are key in the progression of simple hepatic steatosis to MASH in those with T2D. Consequently, MASH progression is accelerated by adipose tissue and muscle insulin resistance driving heightened lipid influx and de novo lipogenesis in the liver, which favors lipotoxicity, altered mitochondrial function, and oxidative stress, according to the study results. Disease progression is driven further by endoplasmic reticulum stress and inflammation. “In order to manage and treat diabetes-related MASH, lifestyle modifications and weight loss remain of critical importance,” Dr. Castera and colleagues wrote.