(07-05-11) Prevalence of and Risk Factors for Hepatic Steatosis and Nonalcoholic Fatty Liver Disease in People With Type 2 Diabetes: the Edinbu

Prevalence of and Risk Factors for Hepatic Steatosis and Nonalcoholic Fatty Liver Disease in People With Type 2 Diabetes: the Edinburgh Type 2 Diabetes Study.


Williamson RM, Price JF, Glancy S, Perry E, Nee LD, Hayes PC, Frier BM, Van Look LA, Johnston GI, Reynolds RM, Strachan MW; on behalf of the Edinburgh Type 2 Diabetes Study Investigators.
Source Metabolic Unit, Western General Hospital, Edinburgh, U.K.

Abstract
OBJECTIVE Type 2 diabetes is an established risk factor for development of
hepatic steatosis and nonalcoholic fatty liver disease (NAFLD). We aimed to
determine the prevalence and clinical correlates of these conditions in a large
cohort of people with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of
939 participants, aged 61-76 years, from the Edinburgh Type 2 Diabetes Study
(ET2DS)-a large, randomly selected population of people with type 2 diabetes-
underwent liver ultrasonography. Ultrasound gradings of steatosis were compared
with magnetic resonance spectroscopy in a subgroup. NAFLD was defined as
hepatic steatosis in the absence of a secondary cause (screened by
questionnaire assessing alcohol and hepatotoxic medication use, plasma
hepatitis serology, autoantibodies and ferritin, and record linkage to
determine prior diagnoses of liver disease). Binary logistic regression was
used to analyze independent associations of characteristics with NAFLD. RESULTS
Hepatic steatosis was present in 56.9% of participants. After excluding those
with a secondary cause for steatosis, the prevalence of NAFLD in the study
population was 42.6%. Independent predictors of NAFLD were BMI, lesser duration
of diabetes, HbA(1c), triglycerides, and metformin use. These remained
unchanged after exclusion of participants with evidence of hepatic fibrosis
from the group with no hepatic steatosis. CONCLUSIONS Prevalences of hepatic
steatosis and NAFLD were high in this unselected population of older people
with type 2 diabetes, but lower than in studies in which ultrasound gradings
were not compared with a gold standard. Associations with features of the
metabolic syndrome could be used to target screening for this condition.

Source:
Diabetes Care. 2011 Apr 8. [Epub ahead of print]
PMID: 21478462 [PubMed - as supplied by publisher]

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