Non‐alcoholic fatty liver disease (<scp>NAFLD</scp>) prevalence and its metabolic associations in patients with type 1 diabetes and type 2 diabetes

Cusi, Kenneth; Sanyal, Arun J.; Zhang, Shuyu; Hartman, Mark L.; Bue-Valleskey, Juliana M.; Hoogwerf, Byron J.; Haupt, Axel

doi:10.1111/dom.12973

Cited by 162 publications

(162 citation statements)

References 20 publications

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“…Hepatic steatosis is known to strongly correlate with high glucose levels . However, until now, only a single study has investigated the association between HGI and NAFLD.…”

Section: Discussionmentioning

confidence: 99%

“…It can progress to steatohepatitis, cirrhosis and even hepatocellular carcinoma, which is associated with high mortality rates . Furthermore, NAFLD has a strong association with metabolic parameters, including HbA1c . In Korea, the prevalence of NAFLD is estimated to be approximately 20‐30% and is rapidly increasing as a result of an increasingly Westernized lifestyle.…”

Section: Introductionmentioning

confidence: 99%

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The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

Yoo

Kang

Cho

et al. 2019

Clinical Endocrinology

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Objectives The hemoglobin glycation index (HGI) quantifies interindividual variations in glycated hemoglobin (HbA1c) and is associated with diabetic complications and metabolic diseases. However, information on the association between HGI and non‐alcoholic fatty liver disease (NAFLD) in healthy subjects is limited, particularly in Asian populations. This study aimed to investigate the association between HGI and NAFLD in a healthy Korean cohort. Design Subjects were stratified in quartiles according to their HGI level. NAFLD was diagnosed by hepatic ultrasonography, hepatic steatosis index and fatty liver index. Multiple logistic regression analysis was performed to evaluate the association between HGI quartiles and the risk of NAFLD. Patients Data from subjects without diabetes who underwent liver ultrasonography during routine health examinations were retrospectively reviewed. Results Data from 14 465 subjects were included in the analysis. The prevalence of NAFLD increased significantly with each HGI quartile (24.8%, 29.7%, 32.6% and 40.6% in quartiles 1‐4, respectively; P < 0.001). In comparison with the lowest HGI quartile group, the highest quartile exhibited worse metabolic parameters, including body weight, waist circumference, body mass index and lipid profiles. Multiple logistic regression analysis adjusted for multiple factors showed that the odds ratio of having NAFLD was 1.564 (95% CI: 1.350‐1.813, P < 0.001) in the highest HGI quartile. Conclusions Elevated HGI levels are independently associated with NAFLD in a healthy Asian population.

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“…Hepatic steatosis is known to strongly correlate with high glucose levels . However, until now, only a single study has investigated the association between HGI and NAFLD.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

Yoo

Kang

Cho

et al. 2019

Clinical Endocrinology

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“…The most recent European Association for the Study of the Liver guidelines recommend screening for fatty liver in patients at risk, including those who meet the criteria for metabolic syndrome (MetS), by obtaining their alanine aminotransferase (ALT) level and a liver ultrasound . Several studies have shown the high burden of NAFLD and advanced fibrosis in patients with type 2 diabetes (T2D), making them a high target for screening . However, multiple issues surround the proposition to screen for NAFLD in high‐risk groups, including the lack of cost‐effectiveness studies.…”

Section: Challenge #1: Most Patients With Nash‐associated Advanced Fimentioning

confidence: 99%

Looking Into the Crystal Ball: Predicting the Future Challenges of Fibrotic NASH Treatment

2019

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Nonalcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease worldwide, and its aggressive form of nonalcoholic steatohepatitis (NASH) is becoming a leading cause for end‐stage liver disease and liver transplantation in the United States. In patients with NASH, the presence of advanced fibrosis is considered the most important prognostic factor in predicting liver‐related morbidity and mortality. Unfortunately, there are no US Food and Drug Administration (FDA)–approved medications to treat patients with NASH‐induced advanced fibrosis. However, the field of drug development to treat NASH and fibrosis has witnessed major advances over the past 5 years with several medications in phase III trials. Results from some of these trials are expected in 2019 with potential FDA approval in 2020. Clinicians who treat patients with NAFLD are likely to face several challenges over the next few years related to identifying patients with advanced fibrosis who may derive most benefit from pharmacologic treatment, the requirement for liver biopsy to assess histologic severity and response to treatment, and the urgent need to validate noninvasive tests to replace liver biopsy—to determine treatment initiation, response, futility, and the need for combination therapy with multiple drugs. Conclusion: In this review, we aim to dissect each of these challenges and attempt to provide suggested solutions while fully realizing that knowledge gaps still exist where future research is likely to provide urgently needed answers.

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“…Liver fat content was assessed at baseline and after insulin treatment in these diabetes cohorts [12]. In correlations of baseline LFC with baseline values of lipoproteins and other soluble biomarkers, we found that large VLDL, VLDL size, Apo C3, and small LDL had the strongest and most consistent positive correlations with LFC, with r values of 0.216‒0.460 across the diabetes cohorts.…”

Section: Discussionmentioning

confidence: 93%

“…Changes in particle size of LDL, HDL, and VLDL were also compared. The objectives and results of the LFC study have been reported elsewhere [11, 12]. …”

Section: Introductionmentioning

confidence: 99%

The effects of basal insulin peglispro vs. insulin glargine on lipoprotein particles by NMR and liver fat content by MRI in patients with diabetes

Orchard

Cariou

Connelly

et al. 2017

Cardiovasc Diabetol

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BackgroundIn Phase 2/3 studies of basal insulin peglispro (BIL) compared to insulin glargine, patients with type 1 or type 2 diabetes previously treated with insulin and randomized to BIL had an increase in serum triglycerides (TGs). To further understand lipoprotein changes, a lipid substudy which included liver fat content was designed to assess relationships among the measured variables for each diabetes cohort and compare the hepato-preferential insulin BIL to glargine.MethodsIn three cohorts of patients with diabetes (type 1, type 2 insulin naïve, and type 2 previously on insulin; n = 652), liver fat content (LFC) was determined by magnetic resonance imaging (MRI) and blood lipids were analyzed by nuclear magnetic resonance (NMR) spectroscopy at baseline, 26 and 52 weeks of treatment. Apolipoproteins, adiponectin, and other lipid parameters were also measured. Descriptive statistics were done, as well as correlation analyses to look for relationships among LFC and lipoproteins or other lipid measures.ResultsIn patients with type 1 diabetes treated with BIL, but not glargine, small LDL and medium and large VLDL subclass concentrations increased from baseline. In patients with type 2 diabetes previously on insulin and treated with BIL, large VLDL concentration increased from baseline. In insulin naïve patients with type 2 diabetes treated with BIL, there were very few changes, while in those treated with glargine, small LDL and large VLDL decreased from baseline. Baseline LFC correlated significantly in one or more cohorts with baseline large VLDL, small LDL, VLDL size, and Apo C3. Changes in LFC by treatment showed generally weak correlations with lipoprotein changes, except for positive correlations with large VLDL and VLDL size. Adiponectin was higher in patients with type 1 diabetes compared to patients with type 2 diabetes, but decreased with treatment with both BIL and glargine.ConclusionsThe lipoprotein changes were in line with the observed changes in serum TGs; i.e., the cohorts experiencing increased TGs and LFC with BIL treatment had decreased LDL size and increased VLDL size. These data and analyses add to the currently available information on the metabolic effects of insulins in a very carefully characterized cohort of patients with diabetes. Clinicaltrials.gov registration numbers and dates NCT01481779 (2011), NCT01435616 (2011), NCT01454284 (2011), NCT01582451 (2012)Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-017-0555-1) contains supplementary material, which is available to authorized users.

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Non‐alcoholic fatty liver disease (NAFLD) prevalence and its metabolic associations in patients with type 1 diabetes and type 2 diabetes

Cited by 162 publications

References 20 publications

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

Looking Into the Crystal Ball: Predicting the Future Challenges of Fibrotic NASH Treatment

The effects of basal insulin peglispro vs. insulin glargine on lipoprotein particles by NMR and liver fat content by MRI in patients with diabetes

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