Endocrine Abstracts

Background: Non-alcoholic fatty liver disease (NAFLD) is metabolic disorder of the liver that is associated with type 2 diabetes.The relationship between NAFLD and diabetic neuropathy was still poorly understood. This study aimed to investigate whether the NAFLD is associated with the autonomic neuropathy parameters in patients with type 2 diabetes.

Methods: A total of 174 patients with type 2 diabetes were included in this study. Patients were divided into two groups based on the presence of NAFLD: 87 type 2 diabetes with NAFLD and 87 type 2 diabetes without NAFLD. The presence of NAFLD was determined in patients using abdominal ultrasonography. Anthropometric measurements, glycated hemoglobin, lipid profile, liver function test were assessed. Autonomic neuropathy testing was performed according to the ADA guidelines. They consists of the valsalva ratio, lying standing heart rate, R-R interval variation, postural hypotension, and sustained handgrip.

Results: Comparing to NAFLD group, mean age of non-NAFLD group was significantly higher (62.84±11.93 vs 54.16±12.93, P<0.05). BMI, ALT and LDL levels were higher in NAFLD group than non-NAFLD group (P<0.05). There was no difference of HbA1c level between two groups. In each autonomic function test parameter, there was no significant difference according to presence of NAFLD in type 2 diabetes patients, except BP response to sustained handgrip. Changes of autonomic function test parameters according to severity of fatty liver were only significantly different in heart rate response to Valsalva. Patients with severe fatty liver were higher in Valsalva ratio than mild and moderate severity groups (P<0.05).

Conclusion: Our study showed that autonomic neuropathy parameters of type 2 diabetes did not demonstrate significantly consistent result according to presence of NAFLD. Further prospective studies are needed to elucidate the association of NAFLD and diabetic autonomic neuropathy.

Keywords: Non-alcoholic fatty liver disease, Diabetic autonomic neuropathy, Type 2 diabetes