T2DM increases the Risk of Hepatic Fibrosis in Individuals with Obesity & NAFLD
Obesity or diabetes mellitus (DM)increases the risk of developing a severe form of liver disease such as nonalcoholic steatohepatitis (NASH) in individuals with past history of Nonalcoholic fatty liver disease (NAFLD). While this has been known, the association between mentioned relation is still unclear. Hence, Diana Barb and colleagues conducted research under the title “Type 2 diabetes mellitus increases the risk of hepatic fibrosis in individuals with obesity and nonalcoholic fatty liver disease” published in the Obesity journal. The summary of this research is given below:
Objective:
To investigate the impact of diabetes mellitus (DM) on nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) in individuals with advanced fibrosis in overweight or obese adults.
Methods:
Patients from the National Health and Nutrition Examination Survey [NHANES] database of 2015-16 were included in the study. Participants included were 834 middle-aged patients with diabetes and 3,007 without DM. United States FLI ≥ 30 or Fatty Liver Index (FLI) ≥ 60 was classified as NAFLD. Participants were categorized into moderate to high risk and high risk of advanced fibrosis depending upon the fibrosis-4 index.
Findings:
The investigators found that liver steatosis is majorly associated with excessive adiposity due to higher BMI and more moderately associated with DM. Secondly, type 2 DM (T2DM) cause advanced fibrosis in overweight or obese individuals. On the other hand, tools used in the screening steatosis show conflicting results and hence call for reappraisal. Altogether, these study findings are in agreement with the ADA 2021 recommendation in context with the need for screening T2DM adults for advanced fibrosis in the existence of increased ALT levels or steatosis.
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