Abstract
Background & aims: Diabetes mellitus is a risk factor for advanced fibrosis in non-alcoholic fatty liver disease. However, not all non-alcoholic fatty liver disease patients with diabetes develop advanced fibrosis. We hypothesised that prescription medications used by these patients influence the development of advanced fibrosis. We investigated the association of commonly used medications and advanced fibrosis in non-alcoholic fatty liver disease patients with diabetes. Methods: Clinical information including demographics, medical history, medication history, biochemical and histologic variables were ascertained in 459 patients with biopsy proven non-alcoholic fatty liver disease. We compared characteristics of patients with and without diabetes and explored potential associations between classes of drugs as risk factors and advanced fibrosis among the diabetic patients with NAFLD. Results: Presence of diabetes was an independent risk factor for advanced fibrosis. In diabetic patients, age (OR 1.09; 95%CI 1.04-1.15, p=0.000) and grade of ballooning (OR 5.59; 95%CI 2.69-11.61, p=0.000) had a positive relationship with advanced fibrosis. The use of insulin (OR 4.95; 95%CI 1.65-14.88, p=0.004) and sulfonylurea (OR 5.07; 95%CI 1.87-13.75, p=0.001) were positively associated while statin use (OR 0.31; 95%CI 0.12-0.78, p=0.013) was negatively associated with advanced fibrosis. Conclusion: Among non-alcoholic fatty liver disease patients with diabetes, the prevalence of advanced fibrosis was higher in patients treated with insulin and sulfonylurea, but lower in patients on statins. These findings provide support for a greater role of statin use in non-alcoholic fatty liver disease patients with diabetes while limiting the use of insulin and sulfonylurea.
Highlights
Non-Alcoholic Fatty Liver Disease (NAFLD) represents a spectrum of histologic abnormalities ranging from steatosis alone to NonAlcoholic Steatohepatitis (NASH), to advanced fibrosis and cirrhosis [1]
The use of insulin and sulfonylurea were positively associated while statin use was negatively associated with advanced fibrosis
Among non-alcoholic fatty liver disease patients with diabetes, the prevalence of advanced fibrosis was higher in patients treated with insulin and sulfonylurea, but lower in patients on statins
Summary
Non-Alcoholic Fatty Liver Disease (NAFLD) represents a spectrum of histologic abnormalities ranging from steatosis alone to NonAlcoholic Steatohepatitis (NASH), to advanced fibrosis and cirrhosis [1]. Patients with type 2 Diabetes Mellitus (DM) have an increased the risk of developing NAFLD while significantly increasing the risk of NASH and hepatic fibrosis/cirrhosis [2,3]. We hypothesised that certain medications used by these patients may have influenced the development of advanced fibrosis in NAFLD patients with DM, as has been observed in other chronic liver disease. Diabetes mellitus is a risk factor for advanced fibrosis in non-alcoholic fatty liver disease. Not all non-alcoholic fatty liver disease patients with diabetes develop advanced fibrosis. We investigated the association of commonly used medications and advanced fibrosis in non-alcoholic fatty liver disease patients with diabetes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
