Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

Dai, Wenjie; Ye, Ling; Liu, Aizhong; Wen, Shi Wu; Deng, Jing; Wu, Xin; Lai, Zhi-Wei

doi:10.1097/md.0000000000008179

Cited by 220 publications

(185 citation statements)

References 48 publications

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“…These data suggest that the prevalence of NAFLD in the general population is 20% to 40% with minor variation by age, region, or ethnicity, and that the incidence of disease is increasing over time in many countries (Table ). A recent meta‐analysis involving 35,599 patients with type 2 diabetes (T2D) reported that the pooled prevalence of NAFLD in these patients was 59.7% . Thus, NAFLD is very common in patients with T2D, with an estimated prevalence of 60% to 80%…”

Section: Introductionmentioning

confidence: 99%

Crosstalk between nonalcoholic fatty liver disease and cardiometabolic syndrome

2018

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Nonalcoholic fatty liver disease (NAFLD) is a chronic condition characterized by fat accumulation combined with low-grade inflammation in the liver. A large body of clinical and experimental data shows that increased flux of free fatty acids from increased visceral adipose tissue and de novo lipogenesis can lead to NAFLD and insulin resistance. Thus, individuals with obesity, insulin resistance, and dyslipidaemia are at the greatest risk of developing NAFLD. Conversely, NAFLD is a phenotype of cardiometabolic syndrome. Notably, researchers have discovered a close association between NAFLD and impaired glucose metabolism and focused on the role of NAFLD in the development of type 2 diabetes. Moreover, recent studies provide substantial evidence for an association between NAFLD and atherosclerosis and cardiometabolic disorders. Even if NAFLD can progress into severe liver disorders including nonalcoholic steatohepatitis (NASH) and cirrhosis, the majority of subjects with NAFLD die from cardiovascular disease eventually. In this review, we propose a potential pathological link between NAFLD/NASH and cardiometabolic syndrome. The potential factors that can play a pivotal role in this link, such as inflammation, insulin resistance, alteration in lipid metabolism, oxidative stress, genetic predisposition, and gut microbiota are discussed. KEYWORDS cardiometabolic syndrome, nonalcoholic fatty liver disease, inflammation, oxidative stress 1 | INTRODUCTION | Prevalence of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH)NAFLD covers a spectrum of diseases ranging from simple steatosis to NASH, which is distinguished from the former by the presence of progressive hepatic fibrosis. 1,2 The prevalence of NAFLD or NASH in the general population varies according to the diagnostic criteria and tools used to stage the condition. 3,4 In the United States, liver biopsies performed on potential liver donors revealed that 20% of donors were ineligible for organ donation because of a high degree of steatosis (>30%). 5 A study in which liver biopsies were performed on 589 consecutive potential liver-transplant donors found an NAFLD prevalence of 51%. 6 A series of autopsies showed a broad range in the prevalence of NAFLD. The prevalence of NASH in autopsy cases of lean Abbreviations: ALT, alanine aminotransferase; apoB, apolipoprotein-B; AST, aspartate aminotransferase; ChREBP, carbohydrate-responsive element-binding protein; CV, cardiovascular; ER, endoplasmic reticulum; FFA, free fatty acid; FIAF, fasting-induced adipocyte factor; GSK-3β, glycogen synthase kinase-3β; IL-6, interleukin-6; IRS1, insulin receptor substrate-1

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Section: Introductionmentioning

confidence: 99%

Crosstalk between nonalcoholic fatty liver disease and cardiometabolic syndrome

2018

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“…Older age (odds ratio (OR) = 1.099, p = 0.001), high body mass index (BMI) (OR = 1.088, p = 0.003), low platelet level (OR = 0.996, p = 0.014), and smoking (OR = 1.653, p = 0.013) are independent risk factors of advanced fibrosis (FibroScan > 10.6 kPa) among T2D patients [21]. The existence of T2D is closely associated not only with advanced fibrosis in cross-sectional data [22][23][24] but also with the rapid progression of hepatic fibrosis based on longitudinal data [14,18,[25][26][27][28]. Conversely, NAFLD patients have a higher risk of incidental T2D compared to non-NAFLD patients [27,28].…”

Section: Association Of T2d With Nash and Nafldmentioning

confidence: 98%

“…Among 10 studies that estimated the prevalence of NASH, the global prevalence of NASH among individuals with T2D is 37.3% (95% CI 24.7-50.0%). Seven studies estimated the prevalence of advanced fibrosis in T2D patients with biopsy-proven NAFLD to be 17% (95% CI 7.2-34.8%) [18]. Among 18.2 million people in the US living with T2D and NAFLD, 6.4 million have NASH [19].…”

Section: Association Of T2d With Nash and Nafldmentioning

confidence: 99%

Antidiabetic Therapy in the Treatment of Nonalcoholic Steatohepatitis

Sumida

Yoneda

Tokushige

et al. 2020

IJMS

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Liver-related diseases are the third-leading causes (9.3%) of mortality in type 2 diabetes (T2D) in Japan. T2D is closely associated with nonalcoholic fatty liver disease (NAFLD), which is the most prevalent chronic liver disease worldwide. Nonalcoholic steatohepatitis (NASH), a severe form of NAFLD, can lead to hepatocellular carcinoma (HCC) and hepatic failure. No pharmacotherapies are established for NASH patients with T2D. Though vitamin E is established as a first-line agent for NASH without T2D, its efficacy for NASH with T2D recently failed to be proven. The effects of pioglitazone on NASH histology with T2D have extensively been established, but several concerns exist, such as body weight gain, fluid retention, cancer incidence, and bone fracture. Glucagon-like peptide 1 (GLP-1) receptor agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors are Int.expected to ameliorate NASH and NAFLD (LEAN study, LEAD trial, and E-LIFT study). Among a variety of SGLT2 inhibitors, dapagliflozin has already entered the phase 3 trial (DEAN study). A key clinical need is to determine the kinds of antidiabetic drugs that are the most appropriate for the treatment of NASH to prevent the progression of hepatic fibrosis, resulting in HCC or liver-related mortality without increasing the risk of cardiovascular or renal events. Combination therapies, such as glucagon receptor agonist/GLP-1 or gastrointestinal peptide/GLP-1, are under development. This review focused on antidiabetic agents and future perspectives on the view of the treatment of NAFLD with T2D.

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“…It is estimated that approximately 7-30% will progress to NASH, which gives an estimated prevalence of NASH between 1Á5% and 6% (Younossi et al, 2016). As much as 60% of patients with type 2 diabetes suffer from NAFLD (Dai et al, 2017). The NASH diagnosis requires a liver biopsy confirming the presence of more than 5% steatosis, hepatocyte ballooning and lobular inflammation (European Association for the Study of the Liver (EASL) et al, 2016).…”

Section: Introductionmentioning

confidence: 99%