Abstract
Patients with diabetes are at increased risk for a spectrum of liver disorders and diseases, including elevated liver enzymes, hepatitis C, NAFLD and nonalcoholic steatohepatitis (NASH), hepatocellular carcinoma, cirrhosis, and acute liver failure ( 1. Tolman K.G. Fonseca V. Dalpiaz A. Tan M.H. Spectrum of liver disease in type 2 diabetes and management of patients with diabetes and liver disease. Diabetes Care. 2007; 30: 734-743 Crossref PubMed Scopus (370) Google Scholar , 2. Cusi K. Role of insulin resistance and lipotoxicity in non-alcoholic steatohepatitis. Clin Liver Dis. 2009; 13: 545-563 Abstract Full Text Full Text PDF PubMed Scopus (178) Google Scholar , 3. Simó R. Hernández C. Genescà J. Jardí R. Mesa J. High prevalence of hepatitis C virus infection in diabetic patients. Diabetes Care. 1996; 19: 998-1000 Crossref PubMed Scopus (239) Google Scholar , 4. Jadoon N.A. Shahzad M.A. Yaqoob R. Hussain M. Ali N. Seroprevalence of hepatitis C in type 2 diabetes: evidence for a positive association. Virol J. 2010; 7: 304 Crossref PubMed Scopus (38) Google Scholar , 5. Porepa L. Ray J.G. Sanchez-Romeu P. Booth G.L. Newly diagnosed diabetes mellitus as a risk factor for serious liver disease. CMAJ. 2010; 182: E526-E531 Crossref PubMed Scopus (87) Google Scholar , 6. El-Serag H. Hampel H. Javadi F. The association between diabetes and hepatocellular carcinoma: a systematic review of epidemiologic evidence. Clin Gastroenterol Hepatol. 2006; 4: 369-380 Abstract Full Text Full Text PDF PubMed Scopus (666) Google Scholar ). NAFLD is the most common liver condition associated with T2DM ( 1. Tolman K.G. Fonseca V. Dalpiaz A. Tan M.H. Spectrum of liver disease in type 2 diabetes and management of patients with diabetes and liver disease. Diabetes Care. 2007; 30: 734-743 Crossref PubMed Scopus (370) Google Scholar ). The prevalence of NAFLD in diabetes is estimated at 34% to 74% but increases to nearly 100% when both diabetes and obesity are present ( 1. Tolman K.G. Fonseca V. Dalpiaz A. Tan M.H. Spectrum of liver disease in type 2 diabetes and management of patients with diabetes and liver disease. Diabetes Care. 2007; 30: 734-743 Crossref PubMed Scopus (370) Google Scholar ). NAFLD is diagnosed based on the clinical findings of hepatic fat accumulation (steatosis) in the absence of another cause of liver disease, such as hepatitis or alcohol abuse. NASH, on the other hand, is diagnosed based on histologic findings of hepatic steatosis plus lobular inflammation, hepatocellular ballooning, or fibrosis ( 7. Adams L.A. Sanderson S. Lindor K.D. Angulo P. The histological course of nonalcoholic fatty liver disease: a longitudinal study of 103 patients with sequential liver biopsies. J Hepatol. 2005; 42: 132-138 Abstract Full Text Full Text PDF PubMed Scopus (756) Google Scholar ).
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