The Burden of NAFLD and Its Characteristics in a Nationwide Population with Type 2 Diabetes

Abstract EN

Objective.

We studied the prevalence of nonalcoholic fatty liver disease (NAFLD) and its clinical correlates in a population of patients with type 2 diabetes mellitus (T2DM).

Methods.

Clinical data of 94,577 T2DM patients were retrieved from 160 diabetes clinics in Italy in a standardized format and centrally analyzed anonymously.

After exclusion of 5967 cases (high or uncertain alcohol intake), in 38,880 the Fatty Liver Index (FLI) was used as a proxy for the diagnosis of NAFLD.

Factors associated with FLI assessed NAFLD (FLI-NAFLD) were evaluated through multivariate analysis.

Results.

FLI-NAFLD was present in 59.6% of patients.

Compared to non-NAFLD, FLI-NAFLD was associated with impairment in renal function, higher albumin excretion, HbA1c and blood pressure, lower HDL cholesterol, and poorer quality of care.

ALT was within normal limits in 73.6% of FLI-NAFLD patients (45.6% if the updated reference values were used).

The prevalence of FLI-NAFLD did not differ if the whole sample (94,577 cases) was examined, irrespective of alcohol intake.

Conclusions.

FLI-NAFLD was present in the majority of T2DM patients of our sample and metabolic derangement, not alcohol consumption, was mainly associated with the disease.

FLI-NAFLD patients have a worse metabolic profile.

ALT levels are not predictive of NAFLD.