Endocrine Abstracts

Background: The severity of non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) population compared with that in normal glucose tolerance (NGT) individuals has not yet been assessed by a quantitative method. We investigated the prevalence and the severity of NAFLD in a T2DM population using controlled attenuation parameter (CAP).

Methods: Subjects who underwent testing for biomarkers related to T2DMand CAP using Fibroscan during a regular health check-up were enrolled. CAP values of 250 and 300 dB/m were selected as the cutoffs for the presence of NAFLD and for moderate to severe NAFLD respectively. Biomarkers related to T2DM included fasting glucose/insulin, C-peptide, HbA1c, glycoalbumin, and HOMA-IR.

Results: Among 340 study participants (T2DM, n=66; pre-diabetes, n=202; and NGT, n=72), the proportion of subjects with NAFLD increased according to the glucose tolerance status (31.9% in NGT; 47.0% in pre-diabetes; and 57.6% in T2DM). The median CAP value was significantly higher in subjects with T2DM (265 dB/m) than in those with pre-diabetes (245 dB/m) or NGT (231 dB/m) (all P<0.05). Logistic regression analysis showed that subjects with moderate to severe NAFLD had a 2.4-fold (odds ratio) higher risk of having T2DM than those without NAFLD (P=0.02; 95% CI 1.13–4.86), and positive correlations between the CAP value and HOMA-IR (ρ=0.407) or C-peptide (ρ=0.402) were demonstrated.

Conclusion: Subjects with T2DM had a higher prevalence of severe NAFLD than those with NGT. Increased hepatic steatosis was independently associated with the presence of T2DM, and insulin resistance induced by hepatic fat may be an important mechanistic connection.