Epidemiology

Nonalcoholic fatty liver predicts heart disease in type 2 diabetics

Last Updated: 2006-01-04 12:50:29 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The results of a prospective, case-controlled trial suggest that the risk of cardiovascular disease is "moderately increased" in type 2 diabetics with nonalcoholic fatty liver disease, according to Italian researchers.

The study was conducted by Dr. Giovanni Targher and colleagues at Sacro Cuore Hospital of Negrar in Verona. It involved 2,103 type 2 diabetics without diagnosed cardiovascular disease at baseline.

During a 5-year follow-up period, 248 subjects developed nonfatal coronary heart disease, defined as nonfatal myocardial infarction or coronary revascularization, ischemic stroke or cardiovascular death. Subjects were compared with 496 controls who remained free of heart disease. The researchers adjusted for age, sex, smoking history, duration of diabetes, hemoglobin A1c, LDL cholesterol, liver enzymes and use of medications.

Dr. Targher reports that nonalcoholic fatty liver disease carried an odds ratio of 1.84 for cardiovascular disease (p < 0.001). Adjustment for metabolic syndrome criteria "appreciably attenuated but did not abolish" the link, reducing the odds ratio to 1.53 (p = 0.02).

In the December issue of Diabetes, the investigators conclude that "the casual detection of nonalcoholic liver disease on an ultrasound in (type 2 diabetics) should alert (clinicians) to the coexistence of multiple underlying cardiovascular risk factors warranting evaluation and treatment as much as the risk for advancing liver disease."

Diabetes 2005;54:3541-3546.