Epidemiology

Nonalcoholic fatty liver disease linked to CVD in type 2 diabetes

Last Updated: 2007-06-04 12:40:11 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Nonalcoholic fatty liver disease (NAFLD) is common in type 2 diabetes patients and is associated with a high prevalence of cardiovascular disease (CVD), according to findings reported in the May issue of Diabetes Care.

Dr. Giovanni Targher, of "Sacro Cuore" Hospital, Negrar, Italy, and colleagues studied 2839 adult outpatients with type 2 diabetes. Main outcome measures were NAFLD, assessed by patient history and liver ultrasound, and manifest vascular disease determined by patient history, record review, electrocardiogram, and echo-Doppler scanning of carotid and lower limb arteries.

Overall, 2421 of the 2839 subjects had hepatic steatosis on ultrasound and the unadjusted prevalence of NAFLD was 69.5%. The authors note that NAFLD was the most common cause (81.5%) of hepatic steatosis on ultrasound.

The prevalence of NAFLD increased with age, from 65.4% among those between the ages of 40 to 59 years to 74.6% among those 60 years of age or older. The age-adjusted prevalence of NAFLD was 71.1% and 68% in men and women, respectively.

Patients with NAFLD compared to those without NAFLD also had "remarkably (p < 0.001) higher age and sex-adjusted prevalences of coronary (26.6% versus 18.3%), cerebrovascular (20.0% versus 13.3%), and peripheral (15.4% versus 10.0%) vascular disease."

Results of logistic regression analysis revealed an association between NAFLD and prevalent CVD, independent of classical risk factors, glycemic control, medications, and metabolic syndrome features.

"These results further confirm the hypothesis that the identification of NAFLD in type 2 diabetes may help in CVD risk prediction," Dr. Targher and colleagues conclude. "Future experimental and follow-up studies are needed to elucidate the possible molecular mechanisms linking NAFLD and CVD and to determine whether NAFLD predicts the development and progression of CVD."

Diabetes Care 2007;30:1212-1218.