Brief Article
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World J Gastroenterol. May 28, 2013; 19(20): 3134-3142
Published online May 28, 2013. doi: 10.3748/wjg.v19.i20.3134
Nonalcoholic fatty liver disease and microvascular complications in type 2 diabetes
Wen-Shan Lv, Rui-Xia Sun, Yan-Yan Gao, Jun-Ping Wen, Rong-Fang Pan, Li Li, Jing Wang, Yu-Xin Xian, Cai-Xia Cao, Ming Zheng
Wen-Shan Lv, Rui-Xia Sun, Yan-Yan Gao, Rong-Fang Pan, Li Li, Jing Wang, Yu-Xin Xian, Cai-Xia Cao, the Department of Internal Medicine, the Affiliated Hospital of Medical College, Qingdao University, Qingdao 266100, Shandong Province, China
Jun-Ping Wen, Ming Zheng, Fujian Provincial Hospital, Fujian Provincial Geriatric Hospital, Fujian Medical University, Fuzhou 350001, Fujian Province, China
Author contributions: Lv WS and Sun RX contributed equally to this work; Lv WS, Gao YY and Zheng M designed the research; Pan RF, Wen JP, Li L, Wang J, Xian YX and Cao CX performed the research; Lv WS analyzed the data and wrote the manuscript.
Supported by Natural Science Foundation of China, No. 81270939, No. 30900510 and No. 81170774; and Natural Science Foundation of Fujian Province, No. 2011J01127
Correspondence to: Ming Zheng, MD, Fujian Provincial Hospital, Fujian Provincial Geriatric Hospital, Fujian Medical University, No. 88 Jiaotong Road, Fuzhou 350001, Fujian Province, China. mingzhengcn@yeah.net
Telephone: +86-591-87557768 Fax: +86-591-87532356
Received: November 28, 2012
Revised: March 6, 2013
Accepted: March 23, 2013
Published online: May 28, 2013
Abstract

AIM: To evaluate the correlation between nonalcoholic fatty liver disease (NAFLD) and microvascular complications in type 2 diabetes mellitus (T2DM).

METHODS: Data were obtained from 1217 inpatients with T2DM (757 females, 460 males; aged 63.39 ± 12.28 years). NAFLD was diagnosed by hepatic ultrasonography. Diabetic nephropathy (DN), diabetic peripheral neuropathy (DPN), and diabetic retinopathy (DR) were diagnosed according to their respective criteria. The prevalence of NAFLD and the independent correlations of clinical characteristics with NAFLD were determined by cross-tabulation and logistic regression, respectively.

RESULTS: Approximately 61% of inpatients with T2DM in Qingdao, China had NAFLD, which decreased significantly with increase in age and prolonged course of diabetes. The prevalence of NAFLD in patients presenting with DN, DPN and DR was 49.4%, 57.2% and 54.9%, respectively. These rates were significantly lower than those of patients without DN, DPN and DR (65.9%, 65.6% and 66.1%, respectively, P < 0.05). Participants with NAFLD had greater body weight, waist circumference (WC), body mass index (BMI), fasting blood glucose (FBG), hemoglobin A1c, alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase, blood pressure, as well as triglyceride (TG) levels and lower high-density lipoprotein (HDL) concentration than those without NAFLD (P < 0.05). NAFLD was positively correlated with BMI, WC, TG, FBG, diastolic blood pressure, and systolic blood pressure but negatively correlated with the duration of diabetes, DR, DPN, DN, and HDL.

CONCLUSION: Despite the benign nature of NAFLD, efforts should be directed toward early diagnosis, intensive blood glucose and blood pressure control, and effective dyslipidemia correction.

Keywords: Nonalcoholic fatty liver disease, Type 2 diabetes mellitus, Diabetic nephropathy, Diabetic retinopathy, Diabetic neuropathy

Core tip: Nonalcoholic fatty liver disease (NAFLD) and diabetic microangiopathy complications represent important burdens for patients with type 2 diabetes mellitus (T2DM). However based on the finding that the prevalence of NAFLD was negatively correlated with age and duration of T2DM, we suggest that NAFLD is benign process and efforts should be directed at strengthening early diagnosis, intensive blood glucose and pressure control, and effective dyslipidemia correction to prevent and minimize occurrence of NAFLD.