The Relationship between Nonalcoholic Fatty Liver Disease and Retinopathy in NHANES III

Lin, Taiyu; Chen, Ying Jen; Chen, Wei‐Liang; Peng, Tao

doi:10.1371/journal.pone.0165970

Cited by 18 publications

(19 citation statements)

References 31 publications

(34 reference statements)

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“…The primary characteristics of nine articles 15 , 16 , 17 , 19 , 20 , 21 , 22 , 23 , 24 included are outlined in Table 1 . Overall, these nine articles from different countries involved 7,170 patients with type 2 diabetes mellitus (4,075 with NAFLD and 3,095 without NAFLD) and the sample size for each study was between 120 and 2,103.…”

Section: Resultsmentioning

confidence: 99%

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Association of non‐alcoholic fatty liver disease with diabetic retinopathy in type 2 diabetic patients: A meta‐analysis of observational studies

Song

Wang

et al. 2021

J of Diabetes Invest

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Aims/Introduction Non‐alcoholic fatty liver disease (NAFLD) is becoming more and more prevalent in type 2 diabetes mellitus. Evidence connecting NAFLD to diabetic retinopathy (DR) is increasing, but the results vary. Thus, we undertook a meta‐analysis to explore the effect of NAFLD on diabetic retinopathy in patients with type 2 diabetes mellitus. Materials and Methods PubMed, Embase, Cochrane and Scopus database were searched for until September 30, 2019. Original studies analyzing the association between NAFLD and diabetic retinopathy in the type 2 diabetic population were included. This meta‐analysis was processed by RevMan 5.3 software. Subgroup analyses based on countries were carried out. The pooled odds ratios and 95% confidence intervals were used to evaluate the association between NAFLD and diabetic retinopathy incidence. The I2 test was used to assess heterogeneity of studies. Results We retrieved 414 articles, and nine studies involving 7,170 patients were included in the final analysis. The pooled effects estimate suggested that NAFLD was not associated with the risk of diabetic retinopathy in patients with type 2 diabetes mellitus. Subgroup analysis suggested that in China, Korea and Iran, patients with type 2 diabetes mellitus with NAFLD had a decreased risk for diabetic retinopathy compared with the non‐NAFLD individuals. However, in Italy and India, patients with type 2 diabetes mellitus with NAFLD had an increased risk for diabetic retinopathy compared with the non‐NAFLD individuals. In addition, no relevance between NAFLD and diabetic retinopathy was found in America. Conclusions On the whole, there was no association between NAFLD and diabetic retinopathy in individuals with type 2 diabetes mellitus. However, subgroup analysis showed that a difference of country may have an influence on the result.

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Section: Resultsmentioning

confidence: 99%

“…Three articles 16 , 19 , 21 explored the impacts of NAFLD on the incidence of non‐proliferative diabetic retinopathy (NPDR). There was no statistical difference in the incidence of NPDR between NAFLD and non‐NAFLD patients (OR = 0.74, 95% CI 0.36–1.51; P = 0.40) (Figure 3 ).…”

Section: Resultsmentioning

confidence: 99%

Association of non‐alcoholic fatty liver disease with diabetic retinopathy in type 2 diabetic patients: A meta‐analysis of observational studies

Song

Wang

et al. 2021

J of Diabetes Invest

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“…Lastly, after stratification of patients with NAFLD according to likelihood of advanced hepatic fibrosis by the NFS, those with high or intermediate NFS values are more than twice as likely to develop T2DM than those with low NFS values 119. Although there is now convincing evidence that NAFLD is strongly associated with the risk of incident CKD in patients with type 1 or type 2 diabetes (as discussed previously), it remains unclear whether NAFLD or NASH are also independent risk factors for diabetic retinopathy (another microvascular complication of diabetes), with evidence limited only to cross-sectional studies with conflicting conclusions 89 136…”

Section: Epidemiological Data Linking Nafld To Risk Of Type 2 Diabetesmentioning

confidence: 99%

Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases

Adams

Anstee

Tilg

et al. 2017

Gut

891

708

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Key physiological functions of the liver, including glucose and lipid metabolism, become disturbed in the setting of non-alcoholic fatty liver disease (NAFLD) and may be associated with a systemic inflammatory '' initiated in part by liver-secreted cytokines and molecules. Consequently, the pathophysiological effects of NAFLD extend beyond the liver with a large body of clinical evidence demonstrating NAFLD to be independently associated with both prevalent and incident cardiovascular disease (CVD), chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). The magnitude of risk of developing these extrahepatic diseases parallels the underlying severity of NAFLD, such that patients with non-alcoholic steatohepatitis (NASH) appear to be at greater risk of incident CVD, CKD and T2DM than those with simple steatosis. Other modifiers of risk may include genetic variants (eg, patatin-like phospholipase domain-containing 3 and trans-membrane 6 superfamily member 2 polymorphisms), visceral adipose tissue accumulation, dietary intake and the gut microbiome. Emerging data also suggest that NAFLD may be a risk factor for colonic neoplasia and reduced bone mineral density, especially among men. Importantly, improvement/resolution of NAFLD is associated with a reduced incidence of T2DM and improved kidney function, adding weight to causality and suggesting liver focused treatments may reduce risk of extrahepatic complications. Awareness of these associations is important for the clinicians such that CVD risk factor management, screening for T2DM and CKD are part of the routine management of patients with NAFLD.

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“…No significant relationship between NAFLD and incident retinopathy was observed in either diabetic or non-diabetic after adjusting for the confounders such as age, gender, ethnicity, and metabolic components. In addition, this same study found no significant increase in DR prevalence in individuals with both DM and NAFLD[ 75 ]. In contrast, prior studies observed a positive association between pediatric NAFLD participants and the degree of retinopathy signs[ 76 ].…”

Section: Retinopathy In Patients With Non-alcoholic Fatty Liver Diseamentioning

confidence: 99%

“…The NHANES III was conducted by the Centers for Disease Control and Prevention using a nationwide probability sample of the United States non-institutionalized civilian population from 1988 to 1994. While a strong association between diabetes and retinopathy was observed, NAFLD was not associated with retinopathy in the non-diabetic population[ 75 ]. No significant relationship between NAFLD and incident retinopathy was observed in either diabetic or non-diabetic after adjusting for the confounders such as age, gender, ethnicity, and metabolic components.…”

Section: Retinopathy In Patients With Non-alcoholic Fatty Liver Diseamentioning

confidence: 99%

Obesity, metabolic syndrome and diabetic retinopathy: Beyond hyperglycemia

Mbata¹,

El-Magd²,

El-Remessy³

2017

WJD

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Diabetic retinopathy (DR) is the most feared ocular manifestation of diabetes. DR is characterized by progressive retinal damage that may eventually result in blindness. Clinically, this blindness is caused by progressive damage to the retinal microvasculature, which leads to ischemia, retinal swelling, and neovascularization. Retinopathy is associated with both type 1 and type 2 diabetes, with DR being the leading cause of new onset blindness in United States adults. Despite this strong association with diabetes, it must be noted that the development of retinopathy lesions is multifactorial and may occur in individuals without an established history of diabetes. Metabolic syndrome is a multifactorial condition of central obesity, hypertriglyceridemia, dyslipidemia, hypertension, fasting hyperglycemia, and insulin resistance. Although several studies examined the individual components observed in the metabolic syndrome in relation to the development of DR, there is conflicting data as to the association of the metabolic syndrome with the development of retinopathy lesions in non-diabetic subjects. This review will summarize the current literature on the evidence of the metabolic syndrome on retinopathy in subjects with and without an established history of diabetes. This review will also discuss some of the mechanisms through which metabolic syndrome can contribute to the development of retinopathy.

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The Relationship between Nonalcoholic Fatty Liver Disease and Retinopathy in NHANES III

Cited by 18 publications

References 31 publications

Association of non‐alcoholic fatty liver disease with diabetic retinopathy in type 2 diabetic patients: A meta‐analysis of observational studies

Association of non‐alcoholic fatty liver disease with diabetic retinopathy in type 2 diabetic patients: A meta‐analysis of observational studies

Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases

Obesity, metabolic syndrome and diabetic retinopathy: Beyond hyperglycemia

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