Factors Associated with Deep Vein Thrombosis in Type 2 Diabetics with Biopsy-Proven Non-alcoholic Fatty Liver Disease

Abstract

Non-alcoholic fatty liver disease (NAFLD) can lead to a prothrombotic stage increasing the risk of deep vein thrombosis (DVT). We aimed to assess the prevalence and factors associated with DVT in patients with type 2 diabetes (T2D) and biopsy-proven NAFLD. Using ICD-codes, all T2D patients who had liver biopsy done for suspected NAFLD were identified and assessed. Patients with secondary causes of hepatic steatosis (Hepatitis, excess alcohol, etc.) were excluded. Liver biopsy was staged as F0-4, advanced fibrosis (AF) being F3-4. A univariable and multivariate analysis was performed to assess factors associated with DVT. A total of 1295 patients were included in the final analysis. DVT was present in 5.5% of these patients. Our cohort consisted of 62% females, 90% were Caucasians, and 90% were obese or overweight (p = 0.59, 0.22, and 0.53, respectively). Mean platelet count was 200.1 ± 82.2 (p = 0.048) and mean HbA1c was 6.9 ± 1.7 (p = 0.71). On multivariate analysis, a 5-year increment in the age at time of T2D diagnosis was associated with 10% increase in likelihood of having DVT (OR {95% CI} 1.1 (1.01, 1.3), p = 0.031). Patients with IBD were 3-times more likely to have DVT than those without IBD and being on furosemide was associated with 2.5-times higher odds of DVT (OR {95% CI} 3.0 (1.3, 7.1), p = 0.012 and 2.5 (1.5, 4.1), p < 0.001, respectively). Our study suggests that older age, stricturing IBD disease, and use of furosemide in T2D with NAFLD increase the risk of DVT. Future prospective studies are required to confirm these findings. Clinical trial registration number: CCF 16-018