Esteatohepatitis no alcohólica y diabetes

doi:10.1016/j.endonu.2016.06.001

Endocrinología y Nutrición

Volume 63, Issue 8, October 2016, Pages 377-379

https://doi.org/10.1016/j.endonu.2016.06.001 Get rights and content

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Bibliografía (20)

J.M. Hazlehurst et al.
Non-alcoholic fatty liver disease and diabetes
Metabolism
(2016)
L. Caballeria et al.
Hígado graso no alcohólico. Documento de posicionamiento de la Sociedad Catalana de Digestología
Gastroenterol Hepatol
(2014)
L. Caballeria et al.
Prevalence and factors associated with the presence of nonalcoholic fatty liver disease in an adult population in Spain
Eur J Gastroenterol Hepatol
(2010)
S.K. Satapathy et al.
Epidemiology and natural history of nonalcoholic fatty liver disease
Sem Liver Dis
(2015)
P. Portillo-Sanchez et al.
High prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus and normal plasma aminotransferase levels
J Clin Endocrinol Metab
(2015)
M.J. Armstrong et al.
Severe asymptomatic non-alcoholic fatty liver disease in routine diabetes care: A multidisciplinary team approach
QJM
(2014)
J.M. Pappachan et al.
Non-alcoholic fatty liver disease: A diabetologist's perspective
Endocrine
(2014)
H.B. Bhatt et al.
Fatty liver disease in diabetes mellitus
Hepato Biliary Surg Nutr
(2015)
C. Saponaro et al.
Nonalcoholic fatty liver disease and type 2 diabetes: Common pathophysiologic mechanisms
Curr Diab Rep
(2015)
Q.M. Anstee et al.
The genetics of NAFLD
Nat Rev Gastroenterol Hepatol
(2013)

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Cited by (3)

Histopathological differences in patients with biopsy-proven non-alcoholic fatty liver disease with and without type 2 diabetes
2018, Endocrinologia, Diabetes y Nutricion
Citation Excerpt :
The usefulness of the NFS and other fibrosis scores may have disparate clinical reliability for NAFLD patients with and without DM, which highlights the heterogeneity of NAFLD phenotype and the NFS can be adjusted in different subsets NAFLD patients. Although NAFLD patients with T2DM had higher prevalence of NASH30 and advanced fibrosis, the potential risk of severe NAFLD cannot be overlooked in patients without T2DM since both NASH and advanced fibrosis occur in a significant proportion of these patients. Patients with NAFLD and T2DM should be properly monitored for optimal control of diabetes, hyperlipidemia, treatment and screening for cardiovascular complications and should also pay attention to the possible progression of NASH and/or advanced/fibrosis.
Prevalence of non-alcoholic fatty liver disease (NAFLD) in developed countries is 30% in the general population and 50% in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to compare the severity of NAFLD, as assessed by liver biopsy and using the non-invasive index NAFLD Fibrosis Score (NFS), in subjects with and without T2DM.
The study sample consisted of 217 patients with biopsy-proven NAFLD. Anthropometric assessments, laboratory tests, histological criteria established by the Non-alcoholic Steatohepatitis Clinical Research Network (NASH CRN), and the NFS were recorded.
Patients with T2DM (n = 36; 16.5%) had higher HOMA-IR values (6.3 ± 3.6 vs. 3.3 ± 2.4; p < 0.0001), GGT levels (125.2 ± 102.3 vs. 82.5 ± 70.6 IU/l; p < 005), and NFS index (−0.6 ± 0.2 vs. −1.8 ± 0.1; p < 0.001) than subjects with no T2DM. Patients with T2DM were found higher rates of NASH (72.2% vs. 48.6%; p < 0.05), advanced steatosis (80.6% vs. 63%; p < 0.05), and liver fibrosis (75% vs. 43.1%, p < 0.05) than patients with no T2DM. Patients with T2DM also had higher NFS values (−0.6 ± 1.2 vs. −1.8 ± 1.8: p = 0.01). A logistic regression analysis adjusting for age, gender and BMI showed a significant independent association between NASH and presence of T2DM (OR = 4.2: 95% CI: 1.4–12.1; p = 0.007). A second model adjusting for the same covariates showed T2DM to be an independent factor associated to advanced fibrosis (OR = 4.1; 95% CI: 1.7–9.7).
Patients with T2DM have more advanced degrees of NAFLD and advanced fibrosis as assessed by liver biopsy and the NFS index. Particular attention should be paid to the study and monitoring of NASH in patients with T2DM.
La prevalencia de la enfermedad hepática grasa no alcohólica (NAFLD) en los países desarrollados es del 30% de la población general y del 50% de los pacientes con diabetes mellitus tipo 2 (DM2). El objetivo de este estudio fue comparar la gravedad de NAFLD evaluado por biopsia hepática y con un índice no invasivo NAFLD Fibrosis Score (NFS) en sujetos con DM2 frente a pacientes no diabéticos.
Este estudio se llevó a cabo entre 217 pacientes con diagnostico mediante biopsia de NAFLD. Se registraron la valoración antropométrica, pruebas de laboratorio, criterios histológicos establecidos por la Red de Investigación Clínica de Esteatohepatitis No Alcohólica (NASH) y NFS.
Los pacientes con DM2 (n = 36; 16,5%) tuvieron más HOMA-IR (6,3 ± 3,6 vs. 3,3 ± 2,4; p < 0,0001), GGT (125,2 ± 102,3 vs. 82,5 ± 70,6 UI/L); p < 0,05) e índice NFS (−0,6 ± 0,2 vs. −1,8 ± 0,1; p < 0,001) que los sujetos sin DM2. Los pacientes con DM2 presentaron mayor porcentaje de EHNA (72,2 vs. 48,6%; p < 0,05), grado avanzado de esteatosis (80,6 vs. 63%; p < 0,05) y fibrosis hepática (75 vs. 43,1%; p < 0,05) que los pacientes sin DM2. Los pacientes con DM2 presentaron también valores más altos de NFS (−0,6 ± 1,2 vs. −1,8 ± 1,8; p = 0,01). El análisis de regresión logística ajustado por edad, sexo e IMC mostró asociación significativa independiente entre la esteatohepatitis y la presencia de DM2 (OR = 4,2; IC 95%: 1,4-12,1; p = 0,007). Un segundo modelo ajustado por las mismas covariables mostró que la DM2 fue un factor independiente asociado a la fibrosis avanzada (OR = 4,1; IC 95%: 1,7-9,7).
Los pacientes con DM2 tienen grados más avanzados de NAFLD y fibrosis avanzada evaluados mediante biopsia hepática y el índice NFS. Debe prestarse especial atención al estudio y seguimiento de la esteatohepatitis en pacientes con DM2.
Fatty Liver Disease in Patients with Prediabetes and Overweight or Obesity
2023, Metabolites
Sex and age differences in the association of fatty liver index-defined non-alcoholic fatty liver disease with cardiometabolic risk factors: a cross-sectional study
2022, Biology of Sex Differences

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EditorialEsteatohepatitis no alcohólica y diabetesNonalcoholic steatohepatitis and diabetes

First page preview

Metabolism

Gastroenterol Hepatol

Prevalence and factors associated with the presence of nonalcoholic fatty liver disease in an adult population in Spain

Eur J Gastroenterol Hepatol

Epidemiology and natural history of nonalcoholic fatty liver disease

Sem Liver Dis

High prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus and normal plasma aminotransferase levels

J Clin Endocrinol Metab

Severe asymptomatic non-alcoholic fatty liver disease in routine diabetes care: A multidisciplinary team approach

QJM

Non-alcoholic fatty liver disease: A diabetologist's perspective

Endocrine

Fatty liver disease in diabetes mellitus

Hepato Biliary Surg Nutr

Nonalcoholic fatty liver disease and type 2 diabetes: Common pathophysiologic mechanisms

Curr Diab Rep

The genetics of NAFLD

Nat Rev Gastroenterol Hepatol

Editorial
Esteatohepatitis no alcohólica y diabetesNonalcoholic steatohepatitis and diabetes