Diabetes patients at high risk of serious NAFLD outcomes
medwireNews: People with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) are at particularly high risk for progression to cirrhosis or hepatocellular carcinoma (HCC) if they have diabetes, say researchers.
The presence of diabetes increased the risk for cirrhosis or HCC 2.30-fold among patients with NAFLD/NASH, making it the most important risk factor for progression. Notably, its presence conferred an even larger 2.92-fold increased risk in matched controls without NAFLD/NASH, leading the researchers to suspect “a significant number” of cases of undiagnosed NAFLD/NASH in the control group.
“Doctors treating patients with diabetes already have a lot to check on – eyes, kidneys, heart risks – but these results remind us that we should not neglect the liver, nor forget to consider the possibility of NASH,” study co-author Naveed Sattar (University of Glasgow, UK) said in a press statement.
He added: “They also remind us that perhaps more efforts are needed to help our patients with diabetes lose weight and cut alcohol.”
As reported in BMC Medicine, the NAFLD/NASH patients were identified from four European primary care databases, representing 0.7% of nearly 19 million patients. Of these, 0.6% developed cirrhosis or HCC during 3.3 years of follow-up, although the researchers believe that many cases remained undetected.
Older age and higher BMI were the only other predictors of progression in the NAFLD/NASH patients, with smoking and hypertension also predicting progression in controls.
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