Endocrine Abstracts

Introduction: Metabolic hepatic steatosis is a common condition in patients with type 2 diabetes, increasing the risk of cardiovascular morbidity and mortality in the absence of early and adequate management. The objective of this study was to evaluate cardiovascular risk in this population by comparing it with diabetic patients without fatty liver disease.

Methods: We conclucted a cross-sectional study including 281 type 2 diabetics followed in Endocrinology Department in collaboration with the Hepato-Gastroenterology Department of Ibn Rochd University Hospital of Casablanca between January 2018 and September 2018. Hepatic steatosis was evaluated by using the non-invasive score (HSI). Patients were divided into three groups with or without hepatic steatosis and group with hepatic steatosis at the advanced stage of fibrosis. The Framingham score was used to assess the risk of a cardiovascular event occurring in the next 10 years, in unknown patients with cardiopathy. A score between 5 and 10% predicts a high risk and a score>15% at very high cardiovascular risk.

Results: Our study included 281 type 2 diabetics of whom 120 patients (42%) had fatty liver. BMI, age, sex were higher in the group of patients with steatosis compared to the group of patients without hepatic steatosis. Hepatic steatosis was correlated with metabolic syndrome (P<0.05). Hepatic steatosis was found to have a very high cardiovascular risk in 44% of patients, with an average Framingham score of 18% (14–35%). This score was higher in patients with steatosis compared with patients without fatty liver (38%). In multivariate analysis after adjustment of all cardiometabolic risk factors, hepatic steatosis was an independent factor associated with a high risk of cardiovascular events (OR=1.67).

Conclusion: Hepatic steatosis is an independent predictor of the occurrence of cardiovascular events in diabetics, hence the need for systematic screening for this condition in all type 2 diabetics and adequate management.