Nonalcoholic fatty liver disease (NAFLD) and diabetes mellitus are common diseases that often coexist and might act synergistically to increase the risk of hepatic and extra-hepatic clinical outcomes. NAFLD affects up to 70–80% of patients with type 2 diabetes mellitus and up to 30–40% of adults with type 1 diabetes mellitus. The coexistence of NAFLD and diabetes mellitus increases the risk of developing not only the more severe forms of NAFLD but also chronic vascular complications of diabetes mellitus. Indeed, substantial evidence links NAFLD with an increased risk of developing cardiovascular disease and other cardiac and arrhythmic complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus. NAFLD is also associated with an increased risk of developing microvascular diabetic complications, especially chronic kidney disease. This Review focuses on the strong association between NAFLD and the risk of chronic vascular complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus, thereby promoting an increased awareness of the extra-hepatic implications of this increasingly prevalent and burdensome liver disease. We also discuss the putative underlying mechanisms by which NAFLD contributes to vascular diseases, as well as the emerging role of changes in the gut microbiota (dysbiosis) in the pathogenesis of NAFLD and associated vascular diseases.

非酒精性脂肪性肝病（NAFLD）和糖尿病是常见疾病，通常共存，并且可能协同作用以增加肝和肝外临床结局的风险。NAFLD影响高达70–80％的2型糖尿病患者和高达30–40％的1型糖尿病成人。NAFLD和糖尿病的共存不仅增加了发展为更严重形式的NAFLD的风险，而且还增加了患糖尿病的慢性血管并发症的风险。实际上，大量证据表明，NAFLD与1型糖尿病或2型糖尿病患者发生心血管疾病以及其他心脏和心律失常并发症的风险增加有关。NAFLD还与发生微血管糖尿病并发症的风险增加相关，特别是慢性肾脏疾病。这篇综述着重于NAFLD与1型糖尿病或2型糖尿病患者的慢性血管并发症风险之间的密切联系，从而促进人们对这种日益普遍和繁重的肝脏疾病的肝外影响的认识有所提高。我们还讨论了NAFLD促成血管疾病的潜在潜在机制，以及肠道菌群变化（营养不良）在NAFLD和相关血管疾病的发病机理中的新兴作用。从而提高了人们对这种日益普遍和繁重的肝脏疾病对肝外影响的认识。我们还讨论了NAFLD促成血管疾病的潜在潜在机制，以及肠道菌群变化（营养不良）在NAFLD和相关血管疾病的发病机理中的新兴作用。从而提高了人们对这种日益普遍和繁重的肝脏疾病对肝外影响的认识。我们还讨论了NAFLD促成血管疾病的潜在潜在机制，以及肠道菌群变化（营养不良）在NAFLD和相关血管疾病的发病机理中的新兴作用。