Diabetes, Metabolic Syndrome and Obesity (Oct 2023)

Clinical Classification of Obesity and Implications for Metabolic Dysfunction-Associated Fatty Liver Disease and Treatment

  • Ding Y,
  • Deng Q,
  • Yang M,
  • Niu H,
  • Wang Z,
  • Xia S

Journal volume & issue
Vol. Volume 16
pp. 3303 – 3329

Abstract

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Yuping Ding,1,2 Quanjun Deng,1,2 Mei Yang,1,2 Haiyan Niu,1,2 Zuoyu Wang,1,2 Shihai Xia1,2 1Department of Gastroenterology and Hepatology, Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin, 300162, People’s Republic of China; 2Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis & Treatment, Tianjin, 300162, People’s Republic of ChinaCorrespondence: Shihai Xia, Department of Gastroenterology and Hepatology, Characteristic Medical Center of the Chinese People’s Armed Police Force; Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis & Treatment, 220, Chenglin Road, Dongli, Tianjin, 300162, People’s Republic of China, Email [email protected]: Obesity,and metabolic dysfunction-associated fatty liver disease (MAFLD) have reached epidemic proportions globally. Obesity and MAFLD frequently coexist and act synergistically to increase the risk of adverse clinical outcomes (both hepatic and extrahepatic). Type 2 diabetes mellitus (T2DM) is the most important risk factor for rapid progression of steatohepatitis and advanced fibrosis. Conversely, the later stages of MAFLD are associated with an increased risk of T2DM incident. According to the proposed criteria, MAFLD is diagnosed in patients with liver steatosis and in at least one in three: overweight or obese, T2DM, or signs of metabolic dysregulation if they are of normal weight. However, the clinical classification and correlation between obesity and MAFLD is more complex than expected. In addition, treatment for obesity and MAFLD are associated with a reduced risk of T2DM, suggesting that liver-based treatments could reduce the risk of developing T2DM. This review describes the clinical classification of obesity and MAFLD, discusses the clinical features of various types of obesity and MAFLD, emphasizes the role of visceral obesity and insulin resistance (IR) in the development of MAFLD,and summarizes the existing treatments for obesity and MAFLD that reduce the risk of developing T2DM.Keywords: obesity, metabolic dysfunction-associated fatty liver disease, phenotypes, type 2 diabetes mellitus, treatment, weight loss

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