IDDF2022-ABS-0126 Quantification of the name change from nafld to mafld in type 2 diabetes

Abstract

<h3>Background</h3> Type 2 Diabetes Mellitus (T2DM) is a comorbidity commonlycomorbidity related to fatty liver and a recently proposed definition of ‘metabolic associated fatty liver disease’ (MAFLD) is thought to be a better encapsulation of fatty liver compared to non-alcoholic fatty liver disease (NAFLD). Yet, despite the significant prevalence of fatty liver amongst T2DM patients, current literature has focused on the general implications of a name change without specify to T2DM patients and the impact of the change in definition in T2DM patients remains limited. Hence, we sought to examine the outcome differences between MAFLD(+)/NAFLD(-) and MAFLD(+)/NAFLD(+) in T2DM patients. <h3>Methods</h3> The current study uses open-source data from the United States National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Fatty liver was retrospectively diagnosed with a fatty liver index ≥60. The 3 groups in the analysis were T2DM patients without fatty liver [MAFLD(-)/NAFLD(-)], T2DM in MAFLD and NAFLD [MAFLD(+)/NAFLD(+)] and T2DM in MAFLD but not NAFLD [MAFLD(+)/NAFLD(-)]. Multivariate survival analysis was conducted with a cox regression and sub-distribution hazard ratio for competing risk events. <h3>Results</h3> A total of 6,727 patients were included and 4982 individuals with T2DM had fatty liver. 2032 were MAFLD(+)/NAFLD(-) and 2,950 patients were MAFLD(+)/NAFLD(+) (IDDF2022-ABS-0126 Figure 1). The change in definition resulted in a 68.89% increase in fatty liver diagnosis. Compared to MAFLD(+)/NAFLD(+), MAFLD(+)/NAFLD(-) were at a higher risk of adverse events including MACE, advance fibrosis, all-cause (IDDF2022-ABS-0126 Figure 2) and cardiovascular-related mortality. In MAFLD(+)/NAFLD(-), viral hepatitis was a major predictor of advance fibrosis (OR: 6.77, CI: 3.92 to 11.7, p&lt;0.001) and all-cause mortality (HR: 1.75, CI: 1.29 to 2.40, p&lt;0.001). <h3>Conclusions</h3> T2DM patients are predisposed to developing fatty liver and the change in definition allows for the inclusion of all hepatic steatosis in T2DM under MAFLD. However, there were significant differences in the outcomes of the patients between MAFLD(+)/NAFLD(-) and MAFLD(+)/NAFLD(+), and there remains much heterogeneity within the included population of MAFLD.