Bibliometric Analysis of Emerging Trends and Hotspots in the Links between Nonalcoholic Steatohepatitis and Diabetes Mellitus from 2004 to 2023

In recent years, the prevalence of nonalcoholic steatohepatitis (NASH) has been rising globally. NASH has been linked to liver fibrosis, cirrhosis, hepatocellular carcinoma (HCC), and liver transplantation (LT), with the progression and severity of NASH closely impacting patients' prognosis. This increasing incidence highlights the urgent need for effective therapeutic strategies and early detection methods to mitigate the progression of the disease and improve patient prognosis. Accumulating evidence indicates that NASH and diabetes mellitus (DM) are interconnected and mutually affect each other. This study utilized bibliometric analysis to assess current publication trends and focal points in the links between NASH and DM, aiming to promote research in this area. We thoroughly searched the Science Citation Index-Expanded (SCI-E) of the Web of Science Core Collection (WoSCC), PubMed, and the Excerpta Medica Database (Embase) to identify relevant articles on the links between NASH and DM from 2004 to 2023. The current publication trends and hotspots in this field were analyzed using the Online Analysis Platform of Literature Metrology, CiteSpace software, VOSviewer, and the R package Bibliometrix. From 2004 to 2023, 943 articles were found that focused on the links between NASH and DM with a noticeable surge in publications since 2015. The United States has taken the primary position in terms of the number of publications. It has also been the most active country in international collaborative efforts. The University of California, San Diego, and Kenneth Cusi were the most productive institution and scholar, respectively. The co-citation keywords cluster labels revealed 10 primary clusters: adiponectin, MAFLD, mortality, NASH, nonalcoholic fatty liver, SGLT2, neurodegeneration, LY2405319, autophagy, and hepatocytes. Recent studies focused on weight loss, fibrosis stage, NAFLD, mortality, and diabetes mellitus. Research on NASH and DM has transitioned from early mechanistic exploration to a current focus on weight management, diabetes control, and fibrosis prevention, particularly through lifestyle interventions and antidiabetic drug therapy. Future studies should integrate lifestyle adjustments with drug development, enhance international cooperation to fill regional research gaps, and achieve more effective management of NASH and DM. Over the past 20 years, global publications on the relationship between NASH and DM have grown rapidly. The current research hotspots focus on weight loss, and the reduction of blood glucose and fibrosis in NASH. Maintaining a healthy diet, exercising regularly, taking appropriate medication, and being vigilant about complications are essential for delaying the progression of NASH and DM. These are also the primary future directions of research. Registration number: 1020973(PROSPERO).