Influencing factors of non-alcoholic fatty liver disease among patients with type 2 diabetes

  Objective  To investigate influencing factors of type 2 diabetes mellitus (T2DM) among patients with non-alcoholic fatty liver disease (NAFLD) and to provide evidences for the prevention and treatment of related diseases.

  Methods  We randomly extracted medical records of 446 T2DM patients hospitalized in a tertiary hospital between 2014 and 2017 and assigned them into a NAFLD group (n = 186) and a non-NAFLD group (n = 260) based on abdominal ultrasonography. Then we collected data on all participants' clinical examinations and laboratory tests, including body mass index (BMI), waist/hip ratio (WHR), carotid intima-media thickness (IMT), hemoglobin A1c (HbA1c), blood lipids, liver function, and renal function. We adopted logistic regression to explore impact factors of NAFLD among the T2DM inpatients.

  Results  Significantly higher BMI (27.71 ± 3.43 kg/m²), WHR (0.932 ± 0.12), right carotid artery IMT (0.968 ± 0.11 mm), serum uric acid (SUA, 307.91 ± 72.89 μmol/L), alanine aminotransferase (34.25 ± 22.13 U/L), triglyceride (TG, 2.52 ± 0.89 mmol/L), total cholesterol (5.41 ± 1.06 mmol/L), low density lipoprotein cholesterol (3.36 ± 0.91mmol/L), and homeostatic model assessment for insulin resistance (HOMA-IR, 4.55 ± 1.06%) were observed among the participants with NAFLD compared to those among the participants without NAFLD (P < 0.05 or P < 0.01 for all). Logistic regression analysis revealed that main risk factors for NAFLD were BMI (β = 0.185), SUA (β = 0.351), TG (β = 0.587), HOMA-IR (β = 0.236), WHR (β = 0.170), and right carotid artery IMT (β = 0.356) among the participants.

  Conclusion  BMI, SUA, TG, WHR, right carotid IMT and insulin resistance are important risk factors for NAFLD among T2DM patients.