Patients with fatty liver and metabolic syndrome are at greater risk for type 2 diabetes than those with metabolic syndrome alone, according to a recent study.
Researchers evaluated 765 patients aged 30 to 75 years collected from the ongoing Genetics of Atherosclerosis Disease Study. All participants had BMI below 40 kg/m2, triglycerides below 6.78 mmol/L and daily alcohol consumption of less than 20 g, with no history of viral hepatitis or renal, malignant or drug-induced liver disease. Computed tomography was used to identify fatty liver (FL) or coronary artery calcification (CAC), and patients were grouped according to presence or absence of FL and/or metabolic syndrome (MS).
MS was observed in 43.9% of the cohort, while 29.8% tested positive for CAC, 21.3% had FL, and 9.4% had type 2 diabetes. Patients with MS had significantly higher blood pressure, adiposity and levels of glucose, insulin, C-reactive protein (CRP), triglycerides and non-high density lipoprotein than controls.
Patients with MS had type 2 diabetes more frequently than controls without MS or FL, while those with MS and FL had diabetes more frequently than those with MS but without FL (P<.001 for men and women). CAC was more common among men, regardless of MS or FL status (P<.05 for all three groups).
After adjusting for age, BMI, total cholesterol levels, CRP and smoking status, logistic regression analysis indicated an association between type 2 diabetes and MS (OR=8.3; 95% CI, 2.7-25.4 for men; OR=8.0; 95% CI, 2.6-24.7 for women), which was higher among participants with MS and FL (OR=12.1; 95% CI, 4.1-36.1 for men; OR=10.6; 95% CI, 3.4-33.7 for women). Investigators also noted that women with MS and FL were at increased risk for CAC (OR=2.34; 95% CI, 1.07-5.12), but no association was observed between CAC and MS alone.
“The data indicate — for the first time — that FL significantly increases the association of MS with type 2 diabetes in both sexes, even after adjusting for traditional risk factors,” the researchers concluded. “These findings are supported by previous epidemiological and animal studies, showing that hepatic steatosis may favor the development of type 2 diabetes.”