Significant liver fibrosis, as assessed by fibroscan, is independently associated with chronic vascular complications of type 2 diabetes: A multicenter study

Mikolašević, Ivana; Rahelić, Dario; Turk-Wensween, T.; Ružić, Alen; Domislović, Viktor; Hauser, Goran; Matić, Tomas; Radić-Krišto, Delfa; Krznarić, Željko; Radić, Mladen; Kanižaj, Tajana Filipec; Martinović, Marko; Jerkić, Helena; Medjimurec, M.; Targher, Giovanni

doi:10.1016/j.diabres.2021.108884

Cited by 21 publications

(16 citation statements)

References 31 publications

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“…The literature search identified 2613 papers, after duplication removal. After abstract evaluations, 16 studies were considered for the full text analysis [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] (Figure 1). Three studies have been excluded, since one is a duplication of previously published results [45], and two works did not report the prevalence of neuropathy in NAFLD positive and negative patients [43,44] (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Association of Nonalcoholic Fatty Liver Disease (NAFLD) with Peripheral Diabetic Polyneuropathy: A Systematic Review and Meta-Analysis

Greco

Nascimbeni

Carubbi

et al. 2021

JCM

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Aims. The relationship between nonalcoholic fatty liver disease (NAFLD) and diabetic polyneuropathy (DPN) has been demonstrated in many studies, although results were conflicting. This meta-analysis aims to summarize available data and to estimate the DPN risk among NAFLD patients. Materials and methods. We performed a comprehensive literature review until 4 June 2021. Clinical trials analyzing the association between NAFLD and DPN were included. Results. Thirteen studies (9614 participants) were included. DPN prevalence was significantly higher in patients with NALFD, compared to patients without NAFLD (OR (95%CI) 2.48 (1.42–4.34), p = 0.001; I2 96%). This finding was confirmed in type 2 diabetes (OR (95%CI) 2.51 (1.33–4.74), p = 0.005; I2 97%), but not in type 1 diabetes (OR (95%CI) 2.44 (0.85–6.99), p = 0.100; I2 77%). Also, body mass index and diabetes duration were higher in NAFLD subjects compared to those without NAFLD (p < 0.001), considering both type 2 and type 1 diabetes. Conclusion. Despite a high heterogeneity among studies, a significantly increased DPN prevalence among type 2 diabetes subjects with NAFLD was observed. This result was not found in type 1 diabetes, probably due to the longer duration of disease. Physicians should pay more attention to the early detection of DPN, especially in patients with NAFLD.

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Section: Resultsmentioning

confidence: 99%

Association of Nonalcoholic Fatty Liver Disease (NAFLD) with Peripheral Diabetic Polyneuropathy: A Systematic Review and Meta-Analysis

Greco

Nascimbeni

Carubbi

et al. 2021

JCM

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“…We previously showed that significant liver fibrosis on VCTE was independently associated with albuminuria and CKD in the general US population [ 14 ]. Moreover, some smaller studies performed in patients with type 2 diabetes (T2D), a major risk factor for advanced fibrosis [ 15 ], found similar results [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 82%

Liver Stiffness, Albuminuria and Chronic Kidney Disease in Patients with NAFLD: A Systematic Review and Meta-Analysis

et al. 2022

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An association between liver stiffness, a surrogate measure of liver fibrosis, and chronic kidney disease (CKD) in patients with nonalcoholic fatty liver disease (NAFLD) has been proposed. However, most studies were small and had low statistical power. We systematically searched PubMed-MEDLINE and Scopus from inception to August 2021 for cross-sectional or cohort studies reporting the association between liver stiffness diagnosed by vibration controlled transient elastography (VCTE) and renal dysfunction. The primary outcome was CKD, defined as a composite of urinary albumin to creatinine ratio (UACR) ≥ 30 mg/g and estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. Measures of association from individual studies were meta-analyzed using random effects models. Of the 526 titles initially scrutinized, 7 cross-sectional studies fulfilled the criteria and were included. For CKD, risk was higher in patients with liver fibrosis assessed by VCTE, compared with patients without (n = 5 studies: OR 2.49, 95% CI 1.89–3.29; test for overall effect z = 6.475, p < 0.001). When increased UACR was considered as an outcome, elevated liver stiffness was associated with a significantly increased risk as well (n = 3 studies: OR 1. 98 95% CI 1.29–3.05; test for overall effect z = 3.113, p = 0.002). Neither analysis showed significant heterogeneity (I2 = 0% and I2 = 46.5%, respectively for the two outcomes). This meta-analysis indicates that elevated liver stiffness is associated with increased odds of kidney outcomes among patients with NAFLD. Wider use of VCTE to screen for advanced fibrosis might help identify patients at risk of end-stage renal disease.

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“…Excluding 18 non-randomized controlled trials and outcome indicators, 18 studies were finally included in this meta-analysis. Fifteen of the 18 studies evaluated the association between NAFLD and DR ( Targher et al, 2008 ; Targher et al, 2010a ; Yoneda et al, 2012 ; Lv et al, 2013 ; Yang et al, 2013 ; Kim et al, 2014 ; Somalwar and Raut, 2014 ; Vendhan et al, 2014 ; Lin et al, 2016 ; Yan et al, 2016 ; Afarideh et al, 2019 ; Zhang et al, 2019 ; Lombardi et al, 2020a ; Mikolasevic et al, 2021 ; Wen et al, 2021 ), five studies evaluated the association between liver fibrosis and DR in patients with NAFLD ( Lombardi et al, 2020a ; Lombardi et al, 2020b ; Sawadjaan Leila and Ong Janus, 2020 ; Leite et al, 2021 ; Mikolasevic et al, 2021 ), and two of these studies included both of the above-mentioned research objectives ( Lombardi et al, 2020a ; Mikolasevic et al, 2021 ). The details of identifying qualified research and the exclusion criteria are given in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

The presence of diabetic retinopathy closely associated with the progression of non-alcoholic fatty liver disease: A meta-analysis of observational studies

Zhang

Tian-Hao

Yue

et al. 2022

Front. Mol. Biosci.

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Background and Objective: Although growing evidence indicates that non-alcoholic fatty liver disease is related to diabetic retinopathy (DR), research results significantly vary. Therefore, we conducted a meta-analysis to assess the association between the progression of non-alcoholic fatty liver disease and the onset of DR.Methods: PubMed, Embase, and Cochrane databases were searched until 7 November 2021. Combined odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the association.Results: We identified 18 studies involving 12,757 patients. The pooled effect assessment showed that liver fibrosis was positively correlated with DR (OR = 1.69, 95%CI 1.30–2.20; p < 0.0001); non-alcoholic fatty liver disease was not associated with the risk of DR (OR = 1.15, 95%CI 0.75-1.76; p = 0.51); non-alcoholic fatty liver disease was positively correlated with DR in patients with type 1 diabetes (OR = 2.96, 95%CI 1.48–5.94; p = 0.002). In patients with type 2 diabetes, there was no association between non-alcoholic fatty liver disease and DR (OR = 0.92, 95%CI 0.59–1.43; p = 0.70). Subgroup analysis showed no correlation in both Asian and Caucasian races.Conclusion: There is a significant correlation between liver fibrosis and DR. This suggests that the ocular examination of DR could be helpful in predicting whether patients with non-alcoholic fatty liver disease would progress to liver fibrosis.

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Significant liver fibrosis, as assessed by fibroscan, is independently associated with chronic vascular complications of type 2 diabetes: A multicenter study

Cited by 21 publications

References 31 publications

Association of Nonalcoholic Fatty Liver Disease (NAFLD) with Peripheral Diabetic Polyneuropathy: A Systematic Review and Meta-Analysis

Association of Nonalcoholic Fatty Liver Disease (NAFLD) with Peripheral Diabetic Polyneuropathy: A Systematic Review and Meta-Analysis

Liver Stiffness, Albuminuria and Chronic Kidney Disease in Patients with NAFLD: A Systematic Review and Meta-Analysis

The presence of diabetic retinopathy closely associated with the progression of non-alcoholic fatty liver disease: A meta-analysis of observational studies

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