More than half of people with T2D have NAFLD

  • Younossi ZM & al.
  • J Hepatol
  • 4 Jul 2019

  • International Clinical Digest
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Takeaway

  • Prevalences of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are high in patients with type 2 diabetes (T2D).
  • Many have underlying advanced fibrosis and experience higher rates of all-cause, cardiovascular, and liver-specific mortality.

Why this matters

  • T2D increases risks for NAFLD, NASH, and adverse outcomes including advanced hepatic fibrosis and mortality.

Study design

  • Meta-analysis of 80 studies published 2003-2018 involving a total 49,419 patients with T2D.
  • Funding: Bristol-Myers Squibb.

Key results

  • Estimated global NAFLD prevalence among patients with T2D was 55.48% (95% CI, 47.26%-63.67%).
  • Regional prevalences: United States, 51.77% (31.33%-71.64%); Latin America, 56.83% (34.05%-76.98%); Europe, 67.97% (62.07%-72.98%); East Asia, 52.04% (45.37%-58.55%); South Asia, 57.87% (52.87%-62.68%); West Asia, 67.29% (60.39%-73.61%); and Africa, 30.39% (11.64%-67.09%).
  • Predicted prevalence of T2D in patients with NAFLD was 47.16/1000 global population.
  • Among T2D patients, estimated global prevalence of NASH was 37.33% (24.70%-50.02%).
  • In 7 studies of biopsied patients with T2D and NAFLD, advanced fibrosis prevalence was 17.02% (7.29%-34.86%).
  • Compared with T2D alone, patients with T2D+NAFLD had higher rates of hypertension (56.96% vs 55.01%), hyperlipidaemia (49.69% vs 43.08%), cardiovascular disease (24.32% vs 21.31%), and peripheral arterial disease (9.14% vs 7.99%).

Limitations

  • Heterogeneity across studies.
  • Small samples of NASH/advanced fibrosis.
  • No pediatric data.

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