Diabetes in NAFLD Patients linked to Increased Hepatic Decompensation and liver Carcinoma risk

Data from a recent meta-analysis of individual participant-level data has shed light on the risks faced by individuals with non-alcoholic fatty liver disease (NAFLD) in relation to type 2 diabetes. The study by Daniel Huang and peers, conducted across six cohorts in the USA, Japan, and Turkey, aimed to assess the risk of hepatic decompensation in people with NAFLD, both with and without type 2 diabetes.

The study analyzed data from a total of 2016 participants, 736 of whom had type 2 diabetes while the remaining 1280 did not. Over a median follow-up period of 2.8 years, 105 participants developed hepatic decompensation, which includes conditions such as ascites, hepatic encephalopathy, or variceal bleeding. The data showed a significantly higher risk of hepatic decompensation in participants with type 2 diabetes compared to those without it at 1 year (3.37% vs 1.07%), 3 years (7.49% vs 2.92%), and 5 years (13.85% vs 3.95%). The association between type 2 diabetes and hepatic decompensation remained consistent even after adjusting for multiple confounders such as age, BMI, and race.

In addition, the study also found that individuals with type 2 diabetes faced a higher risk of developing hepatocellular carcinoma, a type of liver cancer. Over a median follow-up period of 2.9 years, 22 out of 1802 participants analyzed developed incident hepatocellular carcinoma, with a higher risk observed in those with type 2 diabetes compared to those without it at 1 year (1.34% vs 0.09%), 3 years (2.44% vs 0.21%), and 5 years (3.68% vs 0.44%).

These findings underscore the importance of monitoring and managing type 2 diabetes in individuals with NAFLD. The study highlights the need for early intervention and closer surveillance in this high-risk population. By identifying the association between type 2 diabetes and increased risks of hepatic decompensation and hepatocellular carcinoma, healthcare professionals can better assess and develop strategies to improve outcomes for patients with NAFLD. Further research is needed to delve deeper into the underlying mechanisms behind these associations.

Source:

Huang, D. Q., Noureddin, N., Ajmera, V., Amangurbanova, M., Bettencourt, R., Truong, E., Gidener, T., Siddiqi, H., Majzoub, A. M., Oz, D. K., Erden, A., Allen, A. M., … Loomba, R. (2023). Type 2 diabetes, hepatic decompensation, and hepatocellular carcinoma in patients with non-alcoholic fatty liver disease: an individual participant-level data meta-analysis. In The Lancet Gastroenterology & Hepatology. Elsevier BV. https://doi.org/10.1016/s2468-1253(23)00157-7