Международный эндокринологический журнал Том 22, №3, 2026

Актуальність. Метаболічно асоційована стеатотична хвороба печінки (МАСХП) є найпоширенішим хронічним захворюванням печінки, що поєднується з цукровим діабетом 2-го типу (ЦД2) у 50–70 % випадків. Обидва стани мають спільні патогенетичні механізми, насамперед інсулінорезистентність, і супроводжуються підвищеним ризиком серцево-судинної смертності. Мета: оцінити вплив сучасних цукрознижувальних препаратів на перебіг МАСХП у пацієнтів із ЦД2. Матеріали та методи. Проведено наративний огляд літератури з метою узагальнення даних про взаємозв’язок МАСХП і ЦД2 та впливу сучасної цукрознижувальної терапії на перебіг МАСХП. Пошук публікацій здійснювали в базах даних PubMed, Scopus та Web of Science за період 2018–2025 рр. із відбором наукових статей і клінічних досліджень. Результати. Модифікація способу життя й зниження маси тіла залишаються основними складовими лікування. Агоністи рецептора глюкагоноподібного пептиду-1 та інгібітори натрійзалежного котранспортера глюкози 2-го типу демонструють найбільш виражений вплив на перебіг МАСХП, що проявляється поліпшенням кардіометаболічного профілю, зниженням рівнів трансаміназ і регресією метаболічно асоційованого стеатогепатиту. Комбіноване застосування цих класів препаратів може мати синергічний ефект, що підтверджується даними сучасних клінічних досліджень. Нові подвійні та потрійні інкретинові агоністи (тирзепатид, ретатрутид, пемвідутид) демонструють перспективні результати щодо зменшення стеатозу печінки й поліпшення метаболічних показників, однак потребують подальшого підтвердження ефективності й безпеки. Висновки. Комбінація агоністів рецептора глюкагоноподібного пептиду-1 та інгібіторів натрійзалежного котранспортера глюкози 2-го типу може мати клінічно значущі переваги в пацієнтів із МАСХП і ЦД2.

Background. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease coexisting with type 2 diabetes mellitus (T2DM) in 50–70 % of cases. Both conditions share a common pathogenesis due to insulin resistance and are associated with an increased risk of cardiovascular morta­lity. Aim of the study was to assess the impact of modern hypoglycemic drugs on the course of MASLD in patients with T2DM. Materials and methods. This narrative review aimed to analyse the impact of modern glucose-lowering therapy on MASLD progression in patients with T2DM. The literature search was performed in PubMed, Scopus, and Web of Science databases, covering the period 2018–2025, focusing on the pathophysiological link between MASLD and T2DM and the impact of modern glucose-lowering therapies on MASLD progression. Results. Lifestyle modification and weight loss remain the essential elements of treatment. The highest efficacy has been demonstra­ted for glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-dependent glucose cotransporter type 2 inhibitors (SGLT2-Is), which may promote metabolic dysfunction-associated steatohepatitis regression, improve the cardiovascular profile and reduce transaminase levels. Recent clinical data suggest potential synergistic benefits of this combination. Novel dual and triple incretin-based agonists (tirzepatide, retatrutide, pemvidutide) show promi­sing results in reducing steatosis and improving metabolic parameters; however, further clinical trials are required to confirm their efficacy and safety. Conclusions. Combined therapy with GLP-1 RAs and SGLT2-Is appears to provide clinically relevant benefits for MASLD in patients with T2DM.

метаболічно асоційована стеатотична хвороба печінки; цукровий діабет 2-го типу; агоністи рецептора глюкагоноподібного пептиду-1; інгібітори натрійзалежного котранспортера глюкози 2-го типу; огляд

metabolic dysfunction-associated steatotic liver disease; type 2 diabetes mellitus; glucagon-like peptide-1 receptor agonists; sodium-dependent glucose cotransporter type 2 inhibitors; review

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