Diabetes increases risk of liver fibrosis in obese NAFLD patients: Study

A group of researchers conducted a study to assess the impact of diabetes mellitus (DM) on nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) with advanced fibrosis prevalence in adults with overweight or obesity in the United States.

Participants (National Health and Nutrition Examination Survey [NHANES] 2015-2016 database) included 834 middle-aged patients with diabetes mellitus (DM) (21.7%) and 3,007 without DM (78.3%). nonalcoholic fatty liver disease (NAFLD) was defined by Fatty Liver Index (FLI) ≥ 60 or United States FLI (USFLI) ≥ 30. Moderate-to-high and high risk of advanced fibrosis was defined by fibrosis-4 index (FIB-4) ≥ 1.67 and ≥ 2.67, respectively, and nonalcoholic fatty liver disease (NAFLD) fibrosis scores > 0.676 also indicated a high risk.

The results of the study are as follows:

• Nonalcoholic fatty liver disease (NAFLD) prevalence increased with BMI. Steatosis was higher in individuals with overweight with diabetes mellitus (DM) versus without diabetes mellitus (DM) and in individuals with obesity with DM versus without diabetes mellitus (DM)
• Diabetes mellitus (DM) significantly increased the proportion of individuals at moderate-to-high risk of fibrosis
• In the high risk of advanced fibrosis group, the risk almost doubled.
• Among individuals with obesity, diabetes mellitus (DM) increased the proportion of adults with moderate and high risk of fibrosis by 1.8- and 2.5-fold, respectively

Thus, the researchers concluded that in this US cohort, diabetes mellitus (DM)modestly impacted steatosis, which was primarily obesity-driven. diabetes mellitus (DM) added a significant risk of fibrosis to individuals with overweight or obesity, suggesting that screening is imperative in adults with diabetes mellitus (DM).

Reference:

Type 2 diabetes mellitus increases the risk of hepatic fibrosis in individuals with obesity and nonalcoholic fatty liver disease by Diana Barb et al. published in the Obesity Journal.

https://doi.org/10.1002/oby.23263