Nonalcoholic Fatty Liver Disease and Associated Metabolic Risks of Hypertension in Type 2 Diabetes: A Cross-Sectional Community-Based Study

Abstract

The mechanisms facilitating hypertension in diabetes still remain to be elucidated. Nonalcoholic fatty liver disease (NAFLD), which is a higher risk factor for insulin resistance, shares many predisposing factors with diabetes. However, little work has been performed on the pathogenesis of hypertension in type 2 diabetes (T2DM) with NAFLD. The aim of this study is to investigate the prevalence of hypertension in different glycemic statuses and to analyze relationships between NAFLD, metabolic risks, and hypertension within a large community-based population after informed written consent. A total of 9473 subjects aged over 45 years, including 1648 patients with T2DM, were enrolled in this cross-sectional study. Clinical and biochemical parameters of all participants were determined. The results suggested that the patients with prediabetes or T2DM were with higher risks to have hypertension. T2DM with NAFLD had significantly higher levels of blood pressure, triglyceride, uric acid, and HOMA-IR than those without NAFLD. Data analyses suggested that hypertriglyceridemia [OR = 1.773 (1.396, 2.251)], NAFLD [OR = 2.344 (1.736, 3.165)], hyperuricemia [OR = 1.474 (1.079, 2.012)], and insulin resistance [OR = 1.948 (1.540, 2.465)] were associated with the higher prevalence of hypertension independent of other metabolic risk factors in type 2 diabetes. Further studies are needed to focus on these associations.

Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

“…[ 16 ] Additionally, Ding et al found that T2DM patients with NAFLD had significantly higher levels of systolic blood pressure and diastolic blood pressure than T2DM patients without NAFLD. [ 39 ] Based on these findings, it is deduced that NAFLD may be a hepatic manifestation of metabolic syndrome. [ 3 , 4 ] Consistently, this study found that the prevalence of NAFLD in T2DM patients differed significantly with differences in sample characteristics, including obesity, hypertension, and dyslipidemia.…”

Developmental origins of nonalcoholic fatty liver disease as a risk factor for exaggerated metabolic and cardiovascular-renal disease

“…Studies suggest that diagnosing NAFLD may identify those individuals at greater risk for metabolic dysfunction in T2DM (143,228). Epidemiological studies suggest that NAFLD and T2DM coexist (56,66). In a Chinese cohort, NAFLD was implicated in advancing T2DM (123).…”

“…It is unknown whether the liver is a source of the circulating cytokines or whether they contribute to alterations in hypertension-induced CVRD and damage. Future studies are required to fully examine the contributions of hypertension and inflammation on the development of NAFLD and ensuing metabolic dysfunction and CVRD (56,127).…”

Metabolic Stress, Autophagy, and Cardiovascular Aging: from Pathophysiology to Therapeutics

“…NAFLD may also promote premature aging through promoting other metabolic risk factors such as telomerase length loss and hypertension [66]. In a well-controlled cross-sectional study, NAFLD was found to be associated with high prevalence of hypertension independent of other metabolic risk factors [106]. More in depth characterization of mechanisms of NAFLD should help to elucidate the most accurate diagnosis and therapeutics for individual elderly patients [107].…”