Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes

Targher, Giovanni; Bertolini, Lorenzo; Padovani, Roberto; Rodella, Stefano; Zoppini, Giacomo; Pichiri, Isabella; Sorgato, Claudia; Zenari, Luciano; Bonora, Enzo

doi:10.1016/j.jhep.2010.04.030

Cited by 208 publications

(158 citation statements)

References 28 publications

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“…In a study from Egypt, NAFLD was detected in 4.5% of 692 children with T1DM (16). In a study on 202 patients with T1DM, Targher et al (8) detected hepatosteatosis in 44.4% of patients and reported higher HbA1c level, longer DM duration, and higher nephropathy rates in these patients. In that study, it was seen that mean age was higher in diabetic patients with NAFLD than in those without NAFLD (47±12 years vs. 37±12 years).…”

Section: Discussionmentioning

confidence: 96%

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Cardiac Autonomic Functions in Obese Children - Original Article

Tascilar¹,

Yokuşoğlu²,

Boyraz³

et al. 2011

jcrpe

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Hepatosteatosis is an important complication in children with T1DM as it indicates metabolic imbalance and development of peripheral insulin resistance. Lipoprotein is structurally impaired, and secondary to the hyperglycemia, glucose transporter 2-mediated glucose uptake from the circulation by the liver is increased. This results in increased fatty acid and lipoprotein synthesis, which is implied in the pathogenesis (2,3,4). Such hepatic disorders due to causes other than alcohol are termed as non-alcoholic fatty AbstractWhat is already known on this topic? What this study adds?Objective: Metabolic impairment in type 1 diabetes mellitus (T1DM) with poor glycemic control causes insulin resistance, non-alcoholic fatty liver disease (NAFLD), atherosclerosis, and increased carotid intima-media thickness (CIMT). Fetuin-A has a protective effect in cardiovascular disorders and is increased in hepatosteatosis. We aimed to investigate the reliability of fetuin-A levels in early detection of diabetic complications in children with T1DM and to identify a cut-off value that may show poor metabolic control. Methods: The study included 80 patients who had T1DM for at least 5 years and who had no chronic complications or an auto-immune disorder. Blood samples were drawn to measure hemoglobin A1c (HbA1c), biochemical parameters, and fetuin-A levels. Anthropometric parameters were also measured. Percent body fat was calculated. Hepatosteatosis and CIMT were assessed by sonography. Results: Mean age of the patients was 13.5 years. Grade 1 hepatosteatosis was detected in 10%. Patients were stratified into 2 groups based on presence of NAFLD. Fetuin-A level was increased in patients with NAFLD. We identified a fetuin-A cut-off value (514.28 ng/mL; sensitivity: 47.34; specificity: 96.72) that may predict NAFLD. HbA1c and total cholesterol levels were found to be higher in patients with fetuin-A levels above higher the cut-off value. Conclusion: Fetuin-A is a reliable parameter in the prediction of complications and poor glycemic control in patients with T1DM. Keywords: Non-alcoholic fatty liver disease, fetuin-a, type 1 diabetes mellitus, complication Fetuin-A levels could be useful in predicting complications such as hepatosteatosis and atherosclerosis in patients with type 1 diabetes mellitus.Hyperlipidemia and hyperglycemia lead to an increase in fetuin-A production.

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Section: Discussionmentioning

confidence: 96%

“…In this regard, carotid intima-media thickness (CIMT) that reflects premature atherosclerotic changes is an important marker (7). Thus, hepatosteatosis and increased CIMT are complications which may herald poor metabolic control and chronic influences in children with T1DM (8).…”

Section: Introductionmentioning

confidence: 99%

Cardiac Autonomic Functions in Obese Children - Original Article

Tascilar¹,

Yokuşoğlu²,

Boyraz³

et al. 2011

jcrpe

View full text Add to dashboard Cite

show abstract

“…Persons with NAFLD had higher HbA1c (8.4 ± 1.3 vs. 8.0 ± 1.1), lower glomerular filtration rate (GFR), longer duration of diabetes, and higher frequency of abnormal albuminuria, metabolic syndrome, and its individual components. Also, diabetes patients with NAFLD were older (aged 47 ± 12 years vs. 37 ± 12) and more likely to be male and obese than those without NAFLD [74]. In another sample of 343 type 1 diabetes patients, Targher et al found a prevalence of 53.1% for hepatic steatosis.…”

Section: Prevalence Of Nafld In Type 1 Diabetes Patientsmentioning

confidence: 98%

“…Since such long-term complications of type 1 diabetes develop gradually over years, the early detection of risk factors for and precursors of these conditions could facilitate their prognostication and treatment. NAFLD has been correlated to cardiovascular disease in type 1 diabetes patients after adjustment for age, sex, smoking history, diabetes duration, HbA1c, LDL cholesterol, albuminuria, estimated glomerular filtration rate, and presence of the metabolic syndrome [74]. Because the study associated NAFLD with cardiovascular disease independently of these risk factors, it could be possible that NAFLD itself, at least in part, contributes to accelerated atherogenesis.…”

Section: Relation Of Liver Fat To Diabetic Complicationsmentioning

confidence: 98%

Hepatic Steatosis in Type 1 Diabetes

Regnell

Lernmark

2011

Rev Diabet Stud

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■ AbstractIslet autoimmunity in type 1 diabetes results in the loss of the pancreatic β-cells. The consequences of insulin deficiency in the portal vein for liver fat are poorly understood. Under normal conditions, the portal vein provides 75% of the liver blood supply. Recent studies suggest that non-alcoholic fatty liver disease (NAFLD) may be more common in type 1 diabetes than previously thought, and may serve as an independent risk marker for some chronic diabetic complications. The pathogenesis of NAFLD remains obscure, but it has been hypothesized that hepatic fat accumulation in type 1 diabetes may be due to lipoprotein abnormalities, hyperglycemia-induced activation of the transcription factors carbohydrate response element-binding protein (ChREBP) and sterol regulatory element-binding protein 1c (SREBP-1c), upregulation of glucose transporter 2 (GLUT2) with subsequent intrahepatic fat synthesis, or a combination of these mechanisms. Novel approaches to non-invasive determinations of liver fat may clarify the consequences for liver metabolism when the pancreas has ceased producing insulin. This article aims to review the factors potentially contributing to hepatic steatosis in type 1 diabetes, and to assess the feasibility of using liver fat as a prognostic and/or diagnostic marker for the disease. It provides a background and a case for possible future studies in the field.

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“…3 %) and peripheral (24 . 5%) vascular disease in individuals with NAFLD (34) . NAFLD is defined by the accumulation of liver fat >5 % per liver weight, in the presence of < 10 g daily alcohol consumption.…”

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confidence: 98%

Ectopic fat, insulin resistance and non-alcoholic fatty liver disease

Byrne

2013

Proc. Nutr. Soc.

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Non-alcoholic fatty liver disease (NAFLD) is now recognised as the hepatic component of metabolic syndrome (MetS). NAFLD is an example of ectopic fat accumulation in a visceral organ that causes organ-specific disease, and affects risk of other related diseases such as type 2 diabetes and CVD. NAFLD is a spectrum of fat-associated liver conditions that can culminate in end stage liver disease, hepatocellular carcinoma and the need for liver transplantation. Simple steatosis, or fatty liver, occurs early in NAFLD and may progress to non-alcoholic steatohepatitis, fibrosis and cirrhosis with increased risk of hepatocellular carcinoma. Prevalence estimates for NAFLD range from 2 to 44 % in the general population and it has been estimated that NAFLD exists in up to 70 % of people with type 2 diabetes. Although many obese people have NAFLD, there are many obese people who do not develop ectopic liver fat. The aim of this review which is based on a presentation at the Royal Society of Medicine, UK in December 2012 is to discuss development of NAFLD, ectopic fat accumulation and insulin resistance. The review will also describe the relationships between NAFLD, type 2 diabetes and CVD.Ectopic fat: Energy balance: Non-alcoholic fatty liver disease: Cardio-metabolic risk factors: Type 2 diabetes: CVD

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Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes

Cited by 208 publications

References 28 publications

Cardiac Autonomic Functions in Obese Children - Original Article

Cardiac Autonomic Functions in Obese Children - Original Article

Hepatic Steatosis in Type 1 Diabetes

Ectopic fat, insulin resistance and non-alcoholic fatty liver disease

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