The Burden of NAFLD and Its Characteristics in a Nationwide Population with Type 2 Diabetes

Author:

Forlani Gabriele1,Giorda Carlo2,Manti Roberta2,Mazzella Natalia1,De Cosmo Salvatore3,Rossi Maria Chiara4,Nicolucci Antonio4,Di Bartolo Paolo5,Ceriello Antonio6,Guida Pietro7,Study Group AMD-Annals7

Affiliation:

1. Unit of Metabolic Diseases and Clinical Dietetics, “Alma Mater Studiorum” University of Bologna, 40138 Bologna, Italy

2. Diabetes and Metabolism Unit, ASL Turin 5, 10023 Chieri, Italy

3. Unit of Internal Medicine, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy

4. Center for Outcomes Research and Clinical Epidemiology (CORE), 65124 Pescara, Italy

5. Diabetes Unit, AUSL Romagna, 48121 Ravenna, Italy

6. Biomedical Research Institute August Pi Sunyer (IDIBAPS) and Center for Biomedical Research in Diabetes and Associated Metabolic Disorders (CIBERDEM), 08036 Barcelona, Spain

7. AMD (Italian Association of Clinical Diabetologists), 00192 Rome, Italy

Abstract

Objective. We studied the prevalence of nonalcoholic fatty liver disease (NAFLD) and its clinical correlates in a population of patients with type 2 diabetes mellitus (T2DM).Methods. Clinical data of 94,577 T2DM patients were retrieved from 160 diabetes clinics in Italy in a standardized format and centrally analyzed anonymously. After exclusion of 5967 cases (high or uncertain alcohol intake), in 38,880 the Fatty Liver Index (FLI) was used as a proxy for the diagnosis of NAFLD. Factors associated with FLI assessed NAFLD (FLI-NAFLD) were evaluated through multivariate analysis.Results. FLI-NAFLD was present in 59.6% of patients. Compared to non-NAFLD, FLI-NAFLD was associated with impairment in renal function, higher albumin excretion, HbA1c and blood pressure, lower HDL cholesterol, and poorer quality of care. ALT was within normal limits in 73.6% of FLI-NAFLD patients (45.6% if the updated reference values were used). The prevalence of FLI-NAFLD did not differ if the whole sample (94,577 cases) was examined, irrespective of alcohol intake.Conclusions. FLI-NAFLD was present in the majority of T2DM patients of our sample and metabolic derangement, not alcohol consumption, was mainly associated with the disease. FLI-NAFLD patients have a worse metabolic profile. ALT levels are not predictive of NAFLD.

Publisher

Hindawi Limited

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism

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