- People with type 2 diabetes (T2D) have more than twice the risk for severe liver disease (SLD) than the general population.
Why this matters
- Nonalcoholic fatty liver disease is expected to become the primary indication for liver transplantation in the United States in the coming decade.
- Swedish National Diabetes Register data for 406,770 people with T2D matched with the general population (n=2,033,850) by age, sex, and county.
- SLD defined as any cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC), hepatic failure, liver transplantation, or liver disease-related death.
- Funding: Non-industry Swedish sources.
- During median follow-up of 7.7 years, 1.3% with T2D and 0.6% of control patients developed SLD (P<.001>
- HRs in T2D vs controls were:
- 2.28 for SLD,
- 3.18 for HCC, and
- 2.29 for liver disease-related death (all P<.001>
- More SLD events occurred in:
- Men with T2D: 1.40% vs 1.08% women;
- Respective HRs vs controls: 2.37 (95% CI, 2.27-2.48) and 2.15 (2.04-2.27), respectively.
- Higher age, smoking, male sex, hypertension, higher BMI, lower glomerular filtration rate, and microalbuminuria all independently increased SLD risk.
- Statins, higher low-density lipoprotein, and female sex independently lowered SLD risk.
- Lack of risk factor data in controls.
- Short follow-up.