Patients Non-alcoholic fatty liver disease and NASH
NASH is associated with a 2-fold increase in the risk of developing type 2 diabetes
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Patients Non-alcoholic fatty liver disease and NASH
Lee__R
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Several studies have investigated the impact of non-alcoholic fatty liver disease (NASH) on the risk of developing type 2 diabetes, but the diagnostic methods were variable.
This led an Italian team to conduct a meta-analysis of studies assessing the association between the existence of NASH and the occurrence of diabetes and especially its importance. Only observational studies of more than 500 subjects with a duration of at least one year and in which NASH was diagnosed using imaging methods were selected.
The study analyzed 19 observational studies involving 296,439 subjects, including 30.1% with NASH and nearly 16,000 cases of diabetes. The median follow-up was 5 years. Patients with NASH had a higher risk of developing Type 2 diabetes compared to those who did not have NASH (hazard ratio = 2.22, 95% CI = 1.84-2.60, I2 = 79.2%). Patients with severe NASH were also more likely to develop diabetes.
This risk increased with ultrasonographic steatosis scores,but it appears to be even higher in patients with NASH and advanced fibrosis score (HR = 4.74, 3.54-5.94). Sensitivity analyzes did not modify these data, there did not seem to be any publication bias. However, these studies are very heterogeneous and there are no studies that have used liver biopsy.
In conclusion, NASH is significantly associated with a doubling of the risk of developing type 2 diabetes. However, the fact that these studies are observational does not prove the causality of this relationship.
Sources: Mantovani A. et al. Nonalcoholic fatty liver disease and risk of incident type 2 diabetes: a meta-analysis. Diabetes Care 2018; 41: 372-382.
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