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Diabetes Metab Res Rev. 2017 May;33(4). doi: 10.1002/dmrr.2878. Epub 2017 Jan 27.

Occurrence over time and regression of nonalcoholic fatty liver disease in type 2 diabetes.

Author information

1
Diabetes and Metabolism Unit ASL Torino 5, Chieri, Italy.
2
Unit of Metabolic Diseases and Clinical Dietetics, "Alma Mater Studiorum" University of Bologna, Bologna, Italy.
3
IRCCS Casa Sollievo della Sofferenza, Unit of Internal Medicine, San Giovanni Rotondo, Italy.
4
Center for Outcomes Research and clinical Epidemiology (CORE), Pescara, Italy.
5
Department of Clinical and Experimental Medicine, Policlinico Universitario "G. Martino", Messina, Italy.
6
AUSL Diabetes Unit Romagna, Ravenna, Italy.
7
Institut d'Investigacions Biomèdiques August PiiSunyer (IDIBAPS) and Centro de Investigación Biomédicaen Red de Diabetes y Enfermeda des Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
8
IRCCS MultiMedica, Milano, Italy.
9
Statistical Consultant for AMD c/o Associazione Medici Diabetologi, Rome, Italy.
10
AMD (Italian Association of Clinical Diabetologists), Rome, Italy.

Abstract

BACKGROUND:

This analysis was aimed to assess the incidence, regression, and correlated factors of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes, which are poorly known.

METHODS:

Nonalcoholic fatty liver disease (defined as fatty liver index [FLI] score ≥ 60) in patients with type 2 diabetes, and related factors was investigated in a nationwide database containing information from the Italian network of diabetes clinics. A 10% variation of FLI was the cut-off considered in the analyses of a cohort of 5030 patients, which was separately conducted for those who developed, maintained, or recovered from FLI-assessed NAFLD (FLI-NAFLD) over a 3-year period.

RESULTS:

At baseline, FLI-NAFLD was diagnosed in 61.3% of patients. Within the 3-year study period, FLI-NAFLD occurred in 313 patients and remitted in 410. The FLI score remained unchanged in 4307. Body-mass index (odds ratio, 1.45 95%; confidence interval, 1.35-1.55), abdominal obesity (2.11; 1.64-2.72), low HDL cholesterol levels (1.38; 1.02-1.87), and triglycerides (1.20; 1.12-1.28) all emerged as notable negative prognostic factors for the development or maintenance of FLI-NAFLD. The regression rate of FLI-NAFLD was higher among patients who managed to partially control these factors. Male sex and established organ damage, especially kidney function (1.64; 1.12-2.42), were independent risk predictors. Unlike other diabetes complications, FLI-NAFLD was more frequent among younger patients or those with a shorter duration of diabetes.

CONCLUSIONS:

FLI-assessed NAFLD is a dynamic condition, with about 5% of diabetic patients entering or leaving the status every year. Younger male patients with insulin resistance or organ damage have a higher risk of presenting with FLI-NAFLD at baseline, developing FLI-NAFLD within 3 years, and a lower probability of regression.

KEYWORDS:

associated factors; hepatic steatosis; incidence; longitudinal analysis; recovery; type 2 diabetes

PMID:
28032449
DOI:
10.1002/dmrr.2878
[Indexed for MEDLINE]

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