Pathophysiology of Prediabetes
Our goal is to understand the causes and consequences of impaired metabolic health in obesity and normal weight and the role of metabolic dysfunction-associated steatotic liver disease (MASLD) in the pathogenesis of prediabetes, type 2 diabetes and cardiovascular diseases.
In this respect, in 2008, we published the first large cohort study addressing precise phenotyping in metabolically healthy obesity (MHO) and then extended our research to subphenotypes of impaired metabolic in normal weight. To address the mechanisms how MASLD impacts on cardiometabolic diseases, in 2008, we were the first to introduce the concept of hepatokines and are studying their cardiometabolic role in the organ cross-talk.
Our goal is to understand the causes and consequences of impaired metabolic health in obesity and normal weight and the role of metabolic dysfunction-associated steatotic liver disease (MASLD) in the pathogenesis of prediabetes, type 2 diabetes and cardiovascular diseases.
In this respect, in 2008, we published the first large cohort study addressing precise phenotyping in metabolically healthy obesity (MHO) and then extended our research to subphenotypes of impaired metabolic in normal weight. To address the mechanisms how MASLD impacts on cardiometabolic diseases, in 2008, we were the first to introduce the concept of hepatokines and are studying their cardiometabolic role in the organ cross-talk.
Physician Scientist
Physician Scientist
Physician Scientist
TA
Causes, consequences, and treatment of metabolically unhealthy fat distribution
Energy storage capacity under positive energy balance is important for metabolic health. An increased energy intake, particularly after consuming increased amounts of glucose, fructose, and saturated fat, and when energy expenditure is low, results in the storage of energy mostly in the form of triglycerides in adipose tissue.
Causes and cardiometabolic consequences of NAFLD
An unhealthy diet results in increased hepatic de novo lipogenesis and hepatic inflammation. This process is amplified by a lipodystrophy-like phenotype with expansion of visceral adipose tissue. By increased secretion of very low-density lipoproteins, ceramides, pro-coagulants, glucose, and dysregulated secretion of microRNAs and hepatokines, the fatty liver impacts metabolically important organs and tissues and the cardiovascular system.
Treatment of NAFLD
Pathophysiological targeted treatment of hepatic steatosis, e.g. by inhibiting cortisol production in metabolically active tissues, such as the liver, is effective to fight the epidemic of NAFLD.
Recent Publications
Vazquez Arreola, E. ; Gong, Q. ; Hanson, R.L. ; Wang, J. ; Sandforth, L. ; He, S. ; Sandforth, A. ; Qian, X. ; Giacca, M. ; Bornstein, S.R. ; Fritsche, A. ; Stefan, N. ; Preissl, H. ; Gregg, E.W. ; Marx, N. ; Jumpertz von Schwartzenberg, R. ; Li, G. ; Birkenfeld, A.L.
Prediabetes remission and cardiovascular morbidity and mortality: Post-hoc analyses from the Diabetes Prevention Program Outcome study and the DaQing Diabetes Prevention Outcome study.Wang, Y. ; Ram, J. ; Bianchi, C. ; Fiorentino, T.V. ; Kim, S.S. ; Kim, J. ; Ryang, S. ; Del Prato, S. ; Sesti, G. ; Sandforth, L. ; Preissl, H. ; Jumpertz von Schwartzenberg, R. ; Stefan, N. ; Fritsche, A. ; Ha, J. ; Birkenfeld, A.L. ; Bergman, M.
Superiority of 1 h plasma glucose vs fasting plasma glucose, 2 h plasma glucose and HbA1c for the diagnosis of type 2 diabetes.Tao, R. ; Stöhr, O. ; Tok, O. ; Andres-Hernando, A. ; Qiu, W. ; He, B. ; Wang, C. ; Grøntved, L. ; Burant, C.F. ; Hui, S.T. ; Lanaspa, M.A. ; Stefan, N. ; Copps, K.D. ; White, M.F.
Fructose and follistatin potentiate acute MASLD during complete hepatic insulin resistance.Tilg, H. ; Petta, S. ; Stefan, N. ; Targher, G.
Metabolic dysfunction-associated steatotic liver disease in adults: A review.Wang, Y. ; Sandforth, A. ; Jumpertz von Schwartzenberg, R. ; Ganslmeier, M. ; Cheng, Y. ; Sandforth, L. ; Katzenstein, S. ; Machann, J. ; Schick, F. ; Kantartzis, K. ; Preissl, H. ; Fritsche, A. ; Stefan, N. ; Bergman, M. ; Birkenfeld, A.L.
Lifestyle intervention is more effective in high 1-hour post-load glucose than in prediabetes for restoring β-cell function, reducing ectopic fat, and preventing type 2 diabetes.Grieger, J.A. ; Takele, W.W. ; Vesco, K.K. ; Redman, L.M. ; Hannah, W. ; Bonham, M.P. ; Chen, M. ; Chivers, S.C. ; Fawcett, A.J. ; Habibi, N. ; Liu, K. ; Mekonnen, E.G. ; Pathirana, M. ; Quinteros, A. ; Taylor, R. ; Ukke, G.G. ; Zhou, S.J. ; ADA/EASD PMDI (Stefan, N.)
Participant characteristics in the effectiveness of lifestyle interventions to optimize gestational weight gain: A systematic review and meta-analysis.Sandforth, A. ; Vazquez Arreola, E. ; Hanson, R.L. ; Wewer Albrechtsen, N.J. ; Holst, J.J. ; Ahrends, R. ; Coman, C. ; Gerst, F. ; Lorza-Gil, E. ; Cheng, Y. ; Sandforth, L. ; Katzenstein, S. ; Ganslmeier, M. ; Seissler, J. ; Hauner, H. ; Perakakis, N. ; Wagner, R. ; Machann, J. ; Schick, F. ; Peter, A. ; Lehmann, R. ; Weigert, C. ; Maurer, J. ; Preissl, H. ; Heni, M. ; Szendrödi, J. ; Kopf, S. ; Solimena, M. ; Schwarz, P. ; Blüher, M. ; Häring, H.-U. ; Hrabě de Angelis, M. ; Schürmann, A. ; Kabisch, S. ; Mai, K. ; Pfeiffer, A.F.H. ; Bornstein, S. ; Stumvoll, M. ; Roden, M. ; Stefan, N. ; Fritsche, A. ; Birkenfeld, A.L. ; Jumpertz von Schwartzenberg, R.
Prevention of type 2 diabetes through prediabetes remission without weight loss.Mantovani, A. ; Morandin, R. ; Fiorio, V. ; Lando, M.G. ; Stefan, N. ; Tilg, H. ; Byrne, C.D. ; Targher, G.
Glucagon-like peptide-1 receptor agonists improve MASH and liver fibrosis: A meta-analysis of randomised controlled trials.Stefan, N. ; Roden, M.
Diabetes und metabolische-Dysfunktion-assoziierte steatotische Lebererkrankung.Mantovani, A. ; Morandin, R. ; Lando, M.G. ; Fiorio, V. ; Pennisi, G. ; Petta, S. ; Stefan, N. ; Tilg, H. ; Byrne, C.D. ; Targher, G.
Sodium-glucose cotransporter 2 inhibitor use and risk of liver-related events in patients with type 2 diabetes: A meta-analysis of observational cohort studies.Contact
