Type 2 diabetes mellitus in metabolic-associated fatty liver disease vs. type 2 diabetes mellitus non-alcoholic fatty liver disease: a longitudinal cohort analysis

Muthiah, Mark; Ng, Cheng Han; Chan, Kai En; Fu, Clarissa Elysia; Lim, Wen Hui; Tan, Darren Jun Hao; Nah, Benjamin; Kong, Gwyneth; Xiao, Jieling; Yong, Jie Ning; Tan, Bryan C.; Syn, Nicholas; Wang, Jiong‐Wei; Sayed, Nilofer; Tan, Ee Hong; Chew, Nicholas; Dan, Yock Young; Siddiqui, Mohammad Shadab; Sanyal, Arun J.; Noureddin, Mazen

doi:10.1016/j.aohep.2022.100762

Cited by 26 publications

(13 citation statements)

References 39 publications

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“…Some studies have focused on youth rather than adults ( Song et al, 2022b ). Some have also looked at the association between prediabetes and a metric related to NAFLD, called MAFLD, which differs in certain characteristics ( Kolluru et al, 2022 ); however, results regarding MAFLD are not generalizable to NAFLD, given their underlying differences ( Muthiah et al, 2023 ). Two recent studies are similar to ours in using NHANES 2017–2018 data but differ in the cutoffs used to identify NAFLD ( Claypool and Patel, 2022 ; Kim et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Racial/ethnic and gender disparity in the severity of NAFLD among people with diabetes or prediabetes

Shaheen

Schrode²,

Tedlos³

et al. 2023

Front. Physiol.

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Aim: Non-alcoholic fatty liver disease (NAFLD) exhibits a racial disparity. We examined the prevalence and the association between race, gender, and NAFLD among prediabetes and diabetes populations among adults in the United States.Methods: We analyzed data for 3,190 individuals ≥18 years old from the National Health and Nutrition Examination Survey (NHANES) 2017–2018. NAFLD was diagnosed by FibroScan® using controlled attenuation parameter (CAP) values: S0 (none) < 238, S1 (mild) = 238–259, S2 (moderate) = 260–290, S3 (severe) > 290. Data were analyzed using Chi-square test and multinomial logistic regression, adjusting for confounding variables and considering the design and sample weights.Results: Of the 3,190 subjects, the prevalence of NAFLD was 82.6%, 56.4%, and 30.5% (p < 0.0001) among diabetes, prediabetes and normoglycemia populations respectively. Mexican American males with prediabetes or diabetes had the highest prevalence of severe NAFLD relative to other racial/ethnic groups (p < 0.05). In the adjusted model, among the total, prediabetes, and diabetes populations, a one unit increase in HbA1c was associated with higher odds of severe NAFLD [adjusted odds ratio (AOR) = 1.8, 95% confidence level (CI) = 1.4–2.3, p < 0.0001; AOR = 2.2, 95% CI = 1.1–4.4, p = 0.033; and AOR = 1.5, 95% CI = 1.1–1.9, p = 0.003 respectively].Conclusion: We found that prediabetes and diabetes populations had a high prevalence and higher odds of NAFLD relative to the normoglycemic population and HbA1c is an independent predictor of NAFLD severity in prediabetes and diabetes populations. Healthcare providers should screen prediabetes and diabetes populations for early detection of NAFLD and initiate treatments including lifestyle modification to prevent the progression to non-alcoholic steatohepatitis or liver cancer.

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Section: Discussionmentioning

confidence: 99%

Racial/ethnic and gender disparity in the severity of NAFLD among people with diabetes or prediabetes

Shaheen

Schrode²,

Tedlos³

et al. 2023

Front. Physiol.

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“…In general, the presence of metabolic syndrome correlates slightly more with the risk of developing CAD than the presence of MAFLD [ 57 ]. However, when considering patients with type II diabetes, the risk of developing CAD is higher in patients with MAFLD [ 58 , 59 ]. In contrast, the presence of metabolic syndrome in patients with type II diabetes mellitus does not predict a higher incidence of CAD [ 59 ].…”

Section: Mafld and Complication Of Cvdmentioning

confidence: 99%

“…In contrast, the presence of metabolic syndrome in patients with type II diabetes mellitus does not predict a higher incidence of CAD [ 59 ]. It has been shown that the association of MAFLD with T2DM is correlate with more severe insulin resistance, higher BMI and higher visceral adiposity index (VAI), compared to the association of T2DM and metabolic syndrome [ 57 , 58 ]. This research implies that physicians must pay more attention in patients with T2DM and concomitant MAFLD, as they are at higher CAD and cardiovascular risk.…”

Section: Mafld and Complication Of Cvdmentioning

confidence: 99%

From NAFLD to MAFLD: Definition, Pathophysiological Basis and Cardiovascular Implications

Boccatonda¹,

Andreetto

D’Ardes

et al. 2023

Biomedicines

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Non-alcoholic fatty liver disease (NAFLD) is defined as a chronic liver disease characterized by excessive fat accumulation in the liver without another obvious cause (no excessive alcohol consumption, hepatotoxic medications, toxins, viral infections, genetic hepatic diseases), therefore it is an exclusion diagnosis. The term NAFLD literally refers to non-alcohol related hepatopathy and does not adequately correlate with metabolic dysfunction and related cardiovascular risks. Therefore, researchers and scientific societies have moved towards changing the terminology. The novel nomenclature for a metabolic-associated fatty liver disease (MAFLD) has been proposed in 2020 by a group of experts to overcome the issues related to the old terminology. The diagnosis of MAFLD is based on the presence of hepatic steatosis and at least one between these three conditions: type 2 diabetes mellitus (T2DM), obesity or metabolic dysregulation. MAFLD has been shown to be an independent risk factor for cardiovascular diseases and atherosclerosis. It is better related to the main risk factors for atherosclerosis and cardiovascular diseases than NAFLD, such as dyslipidemia, T2DM and hypertension. The aim of this review is to highlight the reasons why the term NAFLD is moving to the term MAFLD, what are the conceptual basis of this choice and its clinical implications, particularly in the cardiovascular field.

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“…Among the latter group, 2950 patients were diagnosed with NAFLD, but 2032 were not. It should be highlighted that the new definition increased fatty liver diagnosis by 68.89% [ 53 ]. Moreover, correlations between NAFLD and T2DM remained strong after adjustment for genetically predicted BMI.…”

Section: Epidemiological Datamentioning

confidence: 99%

Non-Alcoholic Fatty Liver Disease or Type 2 Diabetes Mellitus—The Chicken or the Egg Dilemma

2023

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In clinical practice, we often deal with patients who suffer from non-alcoholic fatty liver disease (NAFLD) concurrent with type 2 diabetes mellitus (T2DM). The etiopathogenesis of NAFLD is mainly connected with insulin resistance (IR) and obesity. Similarly, the latter patients are in the process of developing T2DM. However, the mechanisms of NAFLD and T2DM coexistence have not been fully elucidated. Considering that both diseases and their complications are of epidemic proportions and significantly affect the length and quality of life, we aimed to answer which of these diseases appears first and thereby highlight the need for their diagnosis and treatment. To address this question, we present and discuss the epidemiological data, diagnoses, complications and pathomechanisms of these two coexisting metabolic diseases. This question is difficult to answer due to the lack of a uniform procedure for NAFLD diagnosis and the asymptomatic nature of both diseases, especially at their beginning stages. To conclude, most researchers suggest that NAFLD appears as the first disease and starts the sequence of circumstances leading ultimately to the development of T2DM. However, there are also data suggesting that T2DM develops before NAFLD. Despite the fact that we cannot definitively answer this question, it is very important to bring the attention of clinicians and researchers to the coexistence of NAFLD and T2DM in order to prevent their consequences.

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Type 2 diabetes mellitus in metabolic-associated fatty liver disease vs. type 2 diabetes mellitus non-alcoholic fatty liver disease: a longitudinal cohort analysis

Cited by 26 publications

References 39 publications

Racial/ethnic and gender disparity in the severity of NAFLD among people with diabetes or prediabetes

Racial/ethnic and gender disparity in the severity of NAFLD among people with diabetes or prediabetes

From NAFLD to MAFLD: Definition, Pathophysiological Basis and Cardiovascular Implications

Non-Alcoholic Fatty Liver Disease or Type 2 Diabetes Mellitus—The Chicken or the Egg Dilemma

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