Double Graph Attention Network for predicting non-alcoholic fatty liver disease in patients with type 2 diabetes.

Although non-alcoholic fatty liver disease (NAFLD) is strongly associated with type 2 diabetes mellitus (T2DM), the diagnosis of NAFLD for T2DM patients remains a challenge.This study aimed to investigate the prevalence and risk factors for the NAFLD in T2DM outpatients.This is a retrospective, cross-sectional study that included 2405 T2DM patients treated and admitted for glucose control into the Endocrinology Department of our hospital from April 2017 to March 2019. Using strict exclusion criteria, the target patients were screened and divided into two groups: NAFLD patients (study group) and non-NAFLD patients (control group). Subsequently, 34 factors were compared between the two groups. Furthermore, multivariate analysis of the NAFLD risk factors was performed using logistic regression. Finally, the diagnostic significance of individual biochemical predictors, as well as the combined predictive indicator (CPI), for NAFLD was estimated using receiver operating characteristic (ROC) curve analysis.In this study, the overall prevalence of NAFLD in T2DM patients was 58.67%. Of the target patients, 17 factors were identified by univariate analysis to be associated with NAFLD, and 8 factors were found to be significant predictors for NAFLD using binary logistic regression modeling. Furthermore, the CPI and C-Peptide represent high diagnostic value for NAFLD in T2DM patients.This study provides a more comprehensive risk factor analysis for NAFLD in T2DM patients. These data can be used to provide timely diagnosis and effective management of NAFLD.

Background:Leukocyte telomere has been shown to be related to insulin resistance-related diseases, such as type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). This cross-sectional study investigated the association of leukocyte telomere length (LTL) with NAFLD in T2DM patients.Methods:Clinical features were collected and LTL was measured by Southern blot-based terminal restriction fragment length analysis in 120 T2DM patients without NAFLD and 120 age-matched T2DM patients with NAFLD. NAFLD was clinically defined by manifestations of ultrasonography. The correlation between LTL and clinical and biochemical parameters were analyzed by Pearson correlation or Spearman correlation analysis. Factors for NAFLD in T2DM patients were identified using multiple logistic regressions.Results:LTL in T2DM patients with NAFLD were significantly longer than those without NAFLD (6400.2 ± 71.8 base pairs [bp] vs. 6023.7 ± 49.5 bp, P < 0.001), especially when diabetes duration was less than 2 years. Meanwhile, the trend of shorter LTL was associated with the increased diabetes duration in T2DM patient with NAFLD, but not in T2DM patients without NAFLD. Finally, LTL (odds ratio [OR]: 1.001, 95% confidence interval [CI]: 1.000–1.002, P = 0.001), as well as body mass index (OR: 1.314, 95% CI: 1.169–1.477, P < 0.001) and triglycerides (OR: 1.984, 95% CI: 1.432–2.747, P < 0.001), had a significant association with NAFLD status in T2DM patients.Conclusions:T2DM patients with NAFLD had a significantly longer LTL than those without NAFLD. The longer LTL was especially evident in the early stage of T2DM, indicating that longer LTL may be used as a biomarker for NAFLD in T2DM patients.

Nonalcoholic fatty liver disease (NAFLD) is a common comorbidity of type 2 diabetes mellitus (T2DM). Our aim is to investigate the effects of liraglutide on T2DM with NAFLD. Relevant articles published from the earliest publication to March 2022 were selected from several databases. The Cochrane Collaboration's RevMan software was used for the analysis. Sixteen studies are selected for this meta-analysis, which includes totally 634 patients in the treatment group and 630 patients in the control group. As a result, 14 studies show that fasting plasma glucose levels of the experimental group are lower than that of the control group; 15 studies show that glycosylated hemoglobin A1c levels of the experimental group are lower than that of the control group; 13 studies show that triglyceride levels of the experimental group are lower than that of the control group; twelve studies show that total cholesterol levels of the experimental group are lower than that of the control group; 10 studies show that alanine aminotransferase levels of the experimental group is lower than that of the control group; 10 studies show that no significant difference in changes in aspartate transaminase between 2 groups; 13 studies show that low density lipoprotein cholesterol levels of the experimental group is lower than that of the control group; 9 studies show that no significant difference in changes in high density lipoprotein cholesterol between 2 groups; 7 studies mentioned adverse effects and the difference is significant. Liraglutide is potentially curative for T2DM with NAFLD.

Background:Nonalcoholic fatty liver disease (NAFLD) is emerging as a public health issue worldwide and is highly prevalent in patients with type 2 diabetes mellitus (T2DM). However, there was a great disparity across studies in the estimated prevalence of NAFLD in T2DM patients. This meta-analysis, therefore, aimed to estimate the pooled prevalence of NAFLD in T2DM patients.Methods:Electronic databases of PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure, and Wanfang were searched using MeSH terms to identify relevant studies. Eligibility assessment and data extraction were conducted independently by 2 investigators and a meta-analysis was performed to synthesize the data. Heterogeneity was evaluated using the Cochran Q test and quantified using the I2 statistic. Publication bias was assessed using both the Begg and Egger tests. Subgroup analyses were performed to identify the possible sources of heterogeneity.Results:Twenty-four studies involving 35,599 T2DM patients were included in this meta-analysis, of which 20,264 were identified with NAFLD. A high degree of heterogeneity (I2 = 99.0%, P < .001) was observed among the eligible studies, with the reported prevalence ranging from 29.6% to 87.1%. The pooled prevalence of NAFLD in T2DM patients, by a random-effects model, was 59.67% (95% confidence interval: 54.31–64.92%). Sensitivity was low and both the Begg test and Egger test showed low possibility of publication bias. Subgroup analyses indicated that the prevalence of NAFLD in T2DM patients differed by gender, obesity, hypertension, dyslipidemia, coronary heart disease, and chronic kidney disease.Conclusions:The high pooled prevalence of NAFLD in T2DM patients found in this study significantly underscores the need for early assessment of NAFLD and the importance of strengthening the management of NAFLD in T2DM patients.

Disclosure: M. Parvez: None. U.K. Patel: None. Introduction: Nonalcoholic fatty liver disease (NAFLD) and Type 2 diabetes mellitus (T2DM) commonly exist together and have been regarded as a manifestation of metabolic syndrome. But there are limited studies showing prevalence and association of NAFLD with T2DM patients in US populations. Aims and Objective: Primary outcome of the study was to identify the prevalence and association of NAFLD amongst patients with T2DM amongst the US populations. Methods: A cross-sectional study was performed using the National Health and Nutrition Examination Survey database from 2015 to 2018. Adults with diagnosis of NAFLD and non-NAFLD were identified. We ran univariate analysis using Mann Whitney U test and chi-square test. Multivariable survey logistic regression analysis was performed to find out the association between NAFLD and T2DM. Results: Out of a total 275,968 people, 0.26% had NAFLD. Older population (median: 62 years), male, Mexican American, and people with median household income &amp;gt;$100,000 had a higher prevalence of NAFLD. The diagnosis of NAFLD (40.31% vs 14.23%; p&amp;lt;0.0001) was more prevalent amongst patients with T2DM in comparison to those without NAFLD. In regression analysis, T2DM patients had significantly higher odds of having NAFLD (aOR: 10.40, 95%CI: 10.37- 10.42, p&amp;lt;.0001, c=0.736). Conclusion: Long term follow-up, early identification, and prompt treatment may mitigate the burden of NAFLD in T2DM patients. Presentation: Thursday, June 15, 2023

Increased plasma osteopontin levels are associated with nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is a prevalent cause of chronic liver impairment and is significantly correlated with type 2 diabetes mellitus (T2DM). A liver biopsy is the definitive method for diagnosing NAFLD, but it has substantial restrictions. Pentraxin 3 (PTX3) is an acute phase reactant, and elevated plasma PTX3 levels are considered a sign of NAFLD. Furthermore, T2DM patients exhibited higher Pentraxin 3 serum levels than healthy people. Given that T2DM is a major health concern in Egypt, we intended to investigate the utility of serum Pentraxin 3 as a non-invasive diagnostic of NAFLD in T2DM patients. METHODS: Ninety-six subjects were divided into three equal groups: T2DM with NAFLD, T2DM without NAFLD, and healthy controls. Evaluations included medical history, clinical exams, lab tests (CBC, blood sugar, ALT, AST, creatinine, lipid profile, and Pentraxin), and imaging (ultrasound and Fibroscan). NAFLD diagnosis uses clinical and imaging criteria, with biopsies for unclear cases. RESULTS: When comparing diabetic patients with NAFLD to people with diabetes without NAFLD, at a cut-off value of more than 2.3 ng/mL, Pentraxin 3 has a sensitivity of 87.5%, specificity of 93.75%, positive predictive value of 93.3%, and negative predictive value of 88.2%, with an accuracy of 87.8%. CONCLUSION: This study revealed increased PTX3 levels in diabetic patients with NAFLD compared to people with diabetes without NAFLD and controls. Thus, we showed that Pentraxin 3 is a biomarker for NAFLD with high sensitivity and specificity when suspected in T2DM patients.

Prevalence of nonalcoholic fatty liver disease in type 2 diabetes mellitus patients from the Eastern region of India

Objectives:To analyze the clinicopathological features and risk factors of Type-2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD).Methods:The data of 145 patients with T2DM who received treatment in our hospital from May 2020 to May 2021 were collected. The patients were diagnosed with NAFLD by abdominal liver Doppler ultrasound; The general data and laboratory examination indexes of T2DM patients with and without NAFLD were compared; To analyze the risk factors of NAFLD in T2DM patients.Results:According to the results of the ultrasound examination, 71(48.97%) patients were simple T2DM, and 74(51.03%) patients were T2DM with NAFLD. Compared with simple T2DM, T2DM patients with NAFLD had higher BMI, hypertension, fasting plasma glucose(FPG), insulin resistance, triglycerides (TG), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and uric acid(UA) (P<0.05). Further logistic regression analysis showed a higher BMI (OR=1.841, P=0.013), FPG (OR=1.576, P=0.014), insulin resistance (OR=4.195, P<0.001) and elevated TG (OR=4.676, P=0.042) are risk factors for T2DM with NAFLD.Conclusion:High BMI, BPG, insulin resistance index and TG are independent risk factors for nonalcoholic fatty liver in T2DM patients. During intervention, attention should be paid to the monitoring of these indicators to effectively prevent the aggravation of the disease.

Prevalence and associations of non-alcoholic fatty liver disease (NAFLD) in Sri Lankan patients with type 2 diabetes: A single center study

BackgroundThe objective of this study is to retrospectively analyze the correlation between the thyroid hormones and nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) patients with normal thyroid function. Methods: Totally 586 T2DM patients with normal thyroid function participated in this research and were divided into T2DM without NAFLD (240 cases) group and T2DM with NAFLD (346 cases) group. The NAFLD fibrosis score (NFS) > 0.676 was defined as progressive liver fibrosis and used to categorize the patients into T2DM without progressive liver fibrosis group (493 cases) and T2DM with progressive liver fibrosis group (93 cases). Results: The results indicated that the levels of free triiodothyronine (FT3), total triiodomethylamine (TT3) and FT3/free thyroxine ratio (FT3/FT4) were significantly higher while the FT4 level was lower in T2DM with NAFLD group than that in T2DM without NAFLD group (p < 0.05). The levels of FT3, FT4, TT3 and TT4 in patients with progressive liver fibrosis were significantly lower in patients with progressive liver fibrosis than that in patients without progressive liver fibrosis (p < 0.05). Logistic regression analysis showed a positive connection between FT3/FT4 ratio and NAFLD (p = 0.038), a negative relationship between FT4 level and NAFLD (p = 0.026), between the levels of FT4, TT3 and total thyroxine (TT4) and the risk of progressive hepatic fibrosis (p = 0.022, p = 0.007, p = 0.046).ConclusionThere is a certain correlation between thyroid hormone levels and NAFLD in T2DM patients, suggesting that the assessment of thyroid hormone levels in T2DM patients with normal thyroid function could be helpful in the prevention and treatment of NAFLD.

Background: Non-alcoholic fatty Liver Disease (NAFLD) is a common liver disorder associated with metabolic diseases such as Type 2 Diabetes Mellitus (T2DM).NAFLD often remains undiagnosed, especially in diabetic populations, despite its potential to progress to more severe liver conditions like cirrhosis and hepatocellular carcinoma.This study aims to investigate the prevalence of NAFLD in T2DM patients and explore the key metabolic and clinical factors associated with its development.Methods: This cross-sectional study was conducted on 500 patients with T2DM attending the Department of General Medicine, PRM Medical College & Hospital, Baripada, Odisha.Clinical data, including demographic information, metabolic parameters (obesity, insulin resistance, dyslipidemia), and liver function tests, were collected.NAFLD was diagnosed using ultrasound imaging and liver function tests.Multivariate logistic regression analysis was performed to identify independent risk factors for NAFLD. Results:The prevalence of NAFLD in T2DM patients was found to be 63%.Factors significantly associated with NAFLD included obesity (OR=3.05,p<0.001), insulin resistance (measured by HOMA-IR, OR=2.82, p<0.001), and dyslipidemia (OR=2.34,p=0.01).The odds of having NAFLD were significantly higher in patients with higher waist circumference (OR=2.15,p=0.004) and triglyceride levels (OR=2.41,p=0.02).Age, gender, and hypertension were not significantly associated with NAFLD in this cohort. Conclusion:In this conclusion, the high prevalence of NAFLD in T2DM patients underscores the need for routine screening and targeted interventions to address modifiable risk factors like obesity, insulin resistance, and dyslipidemia.Further research should explore underlying mechanisms and intervention effectiveness.

PurposeThe main objective of this study was to examine the possible association between the atherogenic index of plasma (AIP) and the prevalence of nonalcoholic fatty liver disease (NAFLD) in Chinese individuals with type 2 diabetes mellitus (T2DM).Patients and methodsIn this survey, data from 1074 patients with T2DM were retrospectively extracted. The correlations between each variable and NAFLD were determined by univariate analysis, and then, the statistically significant variables were evaluated for their association with AIP and NAFLD by multivariate regression analysis.ResultsAIP levels were significantly higher in all males and females with NAFLD than those without NAFLD (p<0.001). The prevalence of NAFLD increased progressively throughout the AIP quartiles (trend P < 0.001) and accounted for possible variables in Model 3 of the multivariate logistic regression analysis (OR: 2244.984). In terms of sensitivity and specificity, the AIP index was found to be 65.0% and 90.1% accurate, respectively, with a 95% CI of 0.804–0.893. According to a stratified analysis, females, patients over the age of 56 and current nonsmokers were found to have a higher chance of developing NAFLD.ConclusionT2DM individuals with NAFLD were found to have a higher AIP index than those without NAFLD. The prevalence and progression of NAFLD in T2DM patients may be influenced by the AIP index.

Introduction: A refined diagnostic and classification strategy incorporating phenotypic characteristics of patients with Type 2 Diabetes Mellitus (T2DM) along with their blood glucose profile, lipid levels and evidence of Nonalcoholic Fatty Liver Disease (NAFLD) will help in identifying high risk population. Aim: To determine the prevalence and assess the clinical characteristics of NAFLD in T2DM patients from August 2016 to February 2017. Materials and Methods: This cross-sectional analysis was conducted on 100 T2DM patients with no history of alcohol intake, at the time of their screening. Physical examination and anthropometric measurements such as Body Mass Index (BMI) and Waist to Hip Ratio (WHR) were calculated. Fasting Blood Glucose (FBG), Post-Prandial Blood Glucose (PPBG), glycated haemoglobin (HbA1c), serum bilirubin, liver enzymes, lipid profile and ultrasound of the abdomen to diagnose NAFLD were done. Statistical analysis was carried out using student’s t-test and Statistical Package for the Social Sciences (SPSS) Version 19. Results: The prevalence of NAFLD in T2DM patients was 52%. The mean age was 52.27±1.82 years, with 40% males in the study cohort. There was a significant statistical correlation between the higher BMI (p&lt;0.001), higher WHR (p=0.046), prevalence of upper body obesity (p&lt;0.001) and the presence of NAFLD. The glycaemic control was poorer in patients with NAFLD with higher FBG (p=0.0027), PPBG (p=0.0027) and HbA1c p&lt;0.001) than the non-NAFLD group. The serum cholesterol, triglycerides, Serum Glutamic Pyruvic Transaminase (SGPT), Serum Glutamic Oxaloacetic Transaminase (SGOT) were significantly higher in the NAFLD group. Duration of diabetes was not significantly different among the groups. Conclusion: The incidence of NAFLD is common in T2DM patients with poor glycaemic control, dyslipidaemia, and obesity being associated factors. Duration of diabetes is not a significant predictor of NAFLD.

Nonalcoholic fatty liver disease (NAFLD), an increasingly prevalent paediatric disorder, is diagnosed and managed not only by both pediatric gastroenterologists/hepatologists but also frequently by the general pediatrician. This article updates recent advances in diagnostic and therapeutic approach, which may be applied to everyday practice. Diagnosis of NAFLD takes into account the risk factor profile and is a diagnosis of exclusion. Techniques such as transient elastography and specific biomarkers aimed at improving diagnosis and monitoring of NAFLD need further validation in the pediatric population. Defining the risk to develop cirrhosis seems to be of primary importance already in childhood and a combination of genetic, clinical, and environmental factors can help in monitoring and making decisions on therapy. Weight reduction therapy should be the aim of treatment approach, but the compliance is poor and pharmacological treatment would be helpful; docosahexaenoic acid, some probiotics, and vitamin E are to be considered, but evidence is not sufficient to recommend widespread use.