Prevalence of non-alcoholic fatty liver disease in people with type 2 diabetes
DOI:
https://doi.org/10.51481/amc.v56i1.826Keywords:
Type 2 diabetes mellitus, non-alcoholic fatty liver disease, prevalence, obesityAbstract
Background: Non-alcoholic fatty liver disease is the most common cause of chronic liver disease and there is increasing evidence that it progresses to cirrhosis, liver failure and hepatocellular carcinoma. This condition is very common in diabetics. Given that type 2 diabetes is a highly prevalent chronic disease in the Costa Rican population (10.8% in adults) and that it generates a high negative impact on its health system and mortality rate; it was considered important to
determine the prevalence of non-alcoholic fatty liver disease (including esteatohepatitis) in this specific population.
Methods: A representative sample of diabetic patients (n= 268) of an urban health area (Área 1 de Desamparados) at the primary level was characterized according to its socio-demographic profile, metabolic control, and comorbidity. Non-alcoholic fatty liver disease (NAFLD) was documented through a liver ultrasound and liver enzyme tests were performed to diagnose esteatohepatitis (NASH).
Results: Diabetics were characterized as predominantly female (66.5%), with a mean age of 65.4 years, with low education levels and low and middle income. Prevalence for NAFDL was 72.3% and 14.1% for NASH. NAFDL prevalence also increased significantly with the degree of obesity.
Conclusion: In Costa Rica there is no data on the prevalence of NAFDL. This study has revealed that there is a high prevalence of NAFLD as comorbidity in diabetic patients and its strong association with obesity. Prevention of obesity at the primary health level should be considered as a first step in addressing this disease, as well as diabetes.
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References
Mcavoy N, Ferguson JW, Campbell JW, Hayes P. Non-alcoholic fatty liver disease: natural history, pathogenesis and treatment Br J Diabetes Vasc Dis 2006;6:251-60.
Bellentani S, Marino M. Epidemiology and natural history of non alcoholic fatty liver disease (NAFLD) Ann Hepatol 2009; Suppl 1S 4-8.
Clark JM. The epidemiology of nonalcoholic fatty liver disease in adults. J Clin Gastroenterol 2006; 40 Suppl 1:S5-10.
Lazo M, Hernaez R, Eberhardt MS, Bonekamp S, Kamel I, Guallar et al. Prevalence of Nonalcoholic Fatty Liver Disease in the United States: Am J Epidemiol 2013;178:38-45.
Blachier M, Leleu H, Peck-Radosavljevic M, Valla DC, RoudotThoraval F. The burden of liver disease in Europe: a review of available epidemiological data. J Hepatol 2013;58:593-608.
Jimba S, Nakagami T, Takahashi M, Wakamatsu T, Hirota Y, Iwamoto Y et al. Prevalence of non-alcoholic fatty liver disease and its association with impaired glucose metabolism in Japanese adults. Diabet Med 2005;22:1141-5.
Younossi ZM, Gramlich T, Matteoni CA, Boparai N, McCullough AJ.. Nonalcoholic fatty liver disease in patients with type 2 diabetes. Clin Gastroenterol Hepatol 2004;2:262-5.
Angelico F, Del Ben M, Conti R, Francioso S, Feole K, Fiorello S et al. Insulin resistance, the metabolic syndrome and nonalcoholic fatty liver disease. J Clin Endocrinol & Metabl 2005;90:1578-82.
Fassio E, Alvarez E, Dominguez N, Landeira G, Longo C. Natural history of nonalcoholic steatohepatitis: a longitudinal study of repeat liver biopsies. Hepatology 2004; 40:820-6.
McCullough A.J., Pathophysiology of Nonalcoholic Steatohepatitis J Clin Gastroenterol 2006; 40, Suppl 1:S17-29.
Wong VW, Wong GL, Choi PC, Chan AW, Li MK, Chan HY et al. Disease progression of non-alcoholic fatty liver disease: a prospective study with paired liver biopsies at 3 years. Gut 2010;59:969-974.
Caja Costarricense de Seguro Social, Subárea de Vigilancia Epidemiológica. Vigilancia de Factores de Riesgo Cardiovascular. DDSS, Área de Salud Colectiva. San José 2011.
Ratziu V, Charlotte F, Heurtier A, Gombert S, Giral P, Bruckert E et al. Sampling variability of liver biopsy in non alcoholic fatty liver disease. Gastroenterology 2005;128:1898-906.
Saadeh S, Younossi ZM, Remer EM, Gramlich T, Ong JP, Hurley M et al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology 2002;123:745-750.
Hernaez R, Lazo M, Bonekamp S, Kamel I, Brancati FL, Guallar E et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011;54:1082-1090.
Hamaguchi M, Kojima T, Itoh Y, Yuichi H, Kota F, Tomoaki N, et al. The severity of ultrasonographic finding in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation. Am J Gastroenterology 2007;102:2708-15.
Charatcharoenwitthaya P, Lindor KD. Role of radiology modalities in the management of non-alcoholic esteatohepatitis. Clin. Liver Dis 2007;11:37-54.
Riquelme A, Arrese M, Soza A, Morales A, Baudrand R, Pérez-Ayuso RM et al, Non-alcoholic fatty liver disease and its association with obesity, insulin resistance and increased serum levels of C-reactive protein in Hispanics. Liver Int 2009;29:82-8.
Boppidi H, Daram SR, Nonalcoholic fatty liver disease: hepatic manifestation of obesity and the metabolic syndrome. Postgrad Med 2008;120:EO0-7
Williams CD, Stengel J, Asike MI, Torres DM, Shaw J, Contreras M et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology 2011;140:124-31.
Chan WK, Tan AT, Ratna VS, Tah PC, Anushya V, Goh KL. NonAlcoholic Fatty Liver Disease (NAFLD) in Diabetics - Prevalence and Predictive Factors in a Multi-Racial Hospital Clinic Population in Malaysia. J Gastroenterol Hepato 2013. doi: 10.1111/ jgh.12204. [Epub ahead of print] PubMed PMID: 23517307.
Castro M, Zaineff D, Ramírez JC, Escobedo J. Prevalencia de hígado graso no alcohólico en individuos con síndrome metabólico. Cir Cir 2012;80:128-133
Lazo M, Solga SF, Horska, Bonekamp S, Diehl AM, Brancati FL et al . Effect of a 12 month intensive lifestyle intervention on hepatic steatosis in adults with type 2 diabetes. Diabetes Care 2010; 33:2156-2163.
Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology 2010; 5: 121-129.
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