The Relationship between Hepatic Steatosis, inflammation and insulin Resistance in type 2 Diabetes with Metabolic Imbalance

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Abstract

Aim. Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are in a bidirectional relationship. This prospective study focused on associations between parameters common to the pathogenesis of insulin resistance, inflammation and hepatic steatosis in T2DM patients with metabolic imbalance.

Methods. We used clinical data, insulin resistance and inflammation indices, and hepatic steatosis markers from 120 patients.

Results. The patients (44% men, mean age 58) had a mean body mass index (BMI) of 32 kg/m2 and mean T2DM history of 6 years. With exceptions, significant correlations were found between metabolic, inflammatory and hepatic parameters.

Conclusions. In T2DM patients with poor glycemic control, hepatic steatosis correlates significantly with insulin resistance and inflammation. Increased prevalence and poor prognosis of these diseases together justify the need for NAFLD screening of diabetic patients.

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  • 1. Cleveland E Bandy A and VanWagner LB. Diagnostic Challenges Of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis. Clinical Liver Disease 2018; 11(4) 98-104. DOI:10.1002/cld.716.

  • 2. Younossi ZM. The Epidemiology Of Nonalcoholic Steatohepatitis. Clinical Liver Disease 2018; 11(4):92-94. DOI:10.1002/cld.710.

  • 3. Naim A Scott A. An Update On The Pharmacological Treatment Of Nonalcoholic Fatty Liver Disease: Beyond Lifestyle Modifications. Clinical Liver Disease 2018; 11(4):82-86. DOI:10.1002/cld.708.

  • 4. Fedchuk L Nascimbeni F Pais R et al. Performance And Limitations Of Steatosis Biomarkers In Patients With Nonalcoholic Fatty Liver Disease. Alimentary Pharmacology & Therapeutics 2014; 40(10):1209-1222. DOI:10.1111/apt.12963.

  • 5. Lonardo A Nascimbeni F Maurantonio M et al. Nonalcoholic Fatty Liver Disease: Evolving Paradigms. World Journal Of Gastroenterology 2017; 23(36):6571-6592. DOI:10.3748/wjg.v23.i36.6571.

  • 6. Kitade H Chen G Ni Y and Ota T. Nonalcoholic Fatty Liver Disease And Insulin Resistance: New Insights And Potential New Treatments. Nutrients 2017; 9(4):387. DOI:10.3390/nu9040387.

  • 7. Fruci B Giuliano S Mazza A et al. Nonalcoholic Fatty Liver: A Possible New Target For Type 2 Diabetes Prevention And Treatment. International Journal Of Molecular Sciences 2013; 14(11):22933-22966. DOI:10.3390/ijms141122933.

  • 8. Franch-Nadal J Caballeria L Mata-Cases M et al. Fatty Liver Index Is A Predictor Of Incident Diabetes In Patients With Prediabetes: The PREDAPS Study. PLOS ONE 2018; 13(6):e0198327. DOI:10.1371/journal.pone.0198327.

  • 9. Wallace T Levy J and Matthews D. Use and Abuse of HOMA Modeling. Diabetes Care 2004; 27(6):1487-1495. DOI: 10.2337/diacare.27.6.1487

  • 10. “Fatty Liver Index - Mdcalc”. Mdcalc.Com Available from: https://www.mdcalc.com/fatty-liver-index (accessed at 28 December 2018)

  • 11. “Hepatic Steatosis Index (HSI) Calculator”. Available from: https://www.mdapp.co/hepatic-steatosis-index-hsi-calculator-357/ (accessed at 28 December 2018)

  • 12. “Non-Alcoholic Fatty Liver Disease - Liver Fat Score (NAFLD-LFS) Calculator”. Available from:https://www.mdapp.co/non-alcoholic-fatty-liver-disease-liver-fat-score-nafld-lfs-calculator-358/ (accessed at 28 December 2018)

  • 13. Grigorescu ED Mihai BM Lăcătușu CM et al. Relationships between insulin resistance subclinical inflammation and diastolic dysfunction in type 2 diabetes. Paper presented at the 44th National Congress of the Romanian Society of Diabetes Nutrition and Metabolic Diseases. 23-26 May 2018 Poiana Brasov Romania

  • 14. Gábor Firneisz. Non-alcoholic fatty liver disease and type 2 diabetes mellitus: The liver disease of our age? World J Gastroenterol 2014; 20(27):9072–9089. DOI: 10.3748/wjg.v20.i27.9072

  • 15. Bril F and Kenneth C. Management Of Nonalcoholic Fatty Liver Disease In Patients With Type 2 Diabetes: A Call To Action. Diabetes Care 2017; 40(3):419-430. DOI:10.2337/dc16-1787.

  • 16. Ormazabal V Nair S Elfeky O et al. Association between insulin resistance and the development of cardiovsacular disease. Cardiovasc Diabetol 2018:17-122 DOI: 10.1186/s12933-018-0762-4

  • 17. Frati G Schirone L Chimenti I et al. An overview of the inflammatory signalling mechanism in the myocardium underlying the development of diabetic cardiomyopathy. Cardiovascular Research 2017; 113:378-388.

  • 18. Nishida K Otsu K. Inflammation and metabolic cardiomyopathy. Cardiovascular Research 2017;113:389–398. DOI:10.1093/cvr/cvx012

  • 19. Grigorescu ED Șorodoc V Floria M. The Inflammatory Marker hsCRP as a Predictor of Increased Insulin Resistance in Type 2 Diabetics without Atherosclerotic Manifestations. REV.CHIM.(Bucharest) 2019; 70(5):1791-1794.

  • 20. Elimam H Abdulla AM and Taha IM. Inflammatory Markers And Control Of Type 2 Diabetes Mellitus. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2019; 13(1): 800-804. DOI:10.1016/j.dsx.2018.11.061.

  • 21. Mantovani A Pernigo M Bergamini C et al. Heart Valve Calcification In Patients With Type 2 Diabetes And Nonalcoholic Fatty Liver Disease. Metabolism 2015; 64(8):879-887. DOI:10.1016/j.metabol.2015.04.003.

  • 22. Bonapace S Perseghin G Molon G et al. Nonalcoholic Fatty Liver Disease Is Associated With Left Ventricular Diastolic Dysfunction In Patients With Type 2 Diabetes. Diabetes Care 2011; 35 (2): 389-395. DOI:10.2337/dc11-1820.

  • 23. Tokita Y Maejima Y Shimomura et al. Non-Alcoholic Fatty Liver Disease Is A Risk Factor For Type 2 Diabetes In Middle-Aged Japanese Men And Women. Internal Medicine 2017; 56(7): 763-771. DOI:10.2169/internalmedicine.56.7115.

  • 24. Leoni S Tovoli F Napoli L et al. Current Guidelines For The Management Of Non-Alcoholic Fatty Liver Disease: A Systematic Review With Comparative Analysis. World Journal Of Gastroenterology 2018; 24(30):3361-3373. DOI:10.3748/wjg.v24.i30.3361

  • 25. Kahl S Straßburger K Nowotny B et al. Comparison Of Liver Fat Indices For The Diagnosis Of Hepatic Steatosis And Insulin Resistance. Plos ONE 2014; 9(4):e94059. DOI:10.1371/journal.pone.0094059.

  • 26. Yadav D Choi E Ahn SV et al. Fatty Liver Index As A Simple Predictor Of Incident Diabetes From The Koges-ARIRANG Study. Medicine 2016; 95(31):e4447. DOI:10.1097/md.0000000000004447.

  • 27. Sviklāne L Olmane E Dzērve Z et al. Fatty Liver Index And Hepatic Steatosis Index For Prediction Of Non-Alcoholic Fatty Liver Disease In Type 1 Diabetes. Journal Of Gastroenterology And Hepatology 2017; 33(1):270-276. DOI:10.1111/jgh.13814.

  • 28. Leite NC. Non-Alcoholic Fatty Liver Disease And Diabetes: From Physiopathological Interplay To Diagnosis And Treatment. World Journal Of Gastroenterology 2014; 20(26): 8377. DOI:10.3748/wjg.v20.i26.8377.

  • 29. Marjot T Sbardella E Moola A et al. Prevalence And Severity Of Non-Alcoholic Fatty Liver Disease Are Underestimated In Clinical Practice: Impact Of A Dedicated Screening Approach At A Large University Teaching Hospital. Diabetic Medicine 2017; 35(1):89-98. DOI:10.1111/dme.13540.

  • 30. Byrne CD and Giovanni T. EASL–EASD–EASO Clinical Practice Guidelines For The Management Of Non-Alcoholic Fatty Liver Disease: Is Universal Screening Appropriate?. Diabetologia 2016; 59(6):1141-1144. DOI:10.1007/s00125-016-3910-y.

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