Evidenze, riflessioni e considerazioni sull’ipotesi di uno sviluppo fisiopatologico comune tra diabete di tipo 2, obesità, MASH e declino cognitivo. Esiste un fondamento terapeutico comune per i GLP1 receptor agonist?

To date, type 2 diabetes mellitus (DMT2) is still a major public health problem, in view of its dramatic increasing prevalence and its association with numerous comorbidity and complications. It is widely demonstrated that DMT2 is significant associated with obesity, Metabolic-associated Steatotic Liver Disease (MAFLD), Metabolic dysfunction-associated steatohepatitis (MASH), and cognitive impairment, which are interconnected by many molecular mechanisms such as peripheral and cerebral insulin resistance, inflammation, oxidative stress and endocrine dysfunctions. In this article we have highlighted the putative role played by inflammation and insulin resistance as the key mechanism underling those conditions, the therapeutic rationale for the use of GLP1 receptor agonists (GLP1-RA) and the prospects. Although further studies are needed, the identification of the involved molecular mechanisms may represent an opportunity to find novel and early biomarkers and new potential therapeutic targets for the management and treatment of these chronic and complex diseases.