Objective: To study the prevalence and risk factors of nonalcoholic fatty liver (NAFL) of patients with type 2 diabetes.
Methods: A total of 1335 patients with type 2 diabetes were divided into NAFL group and control group according to type B ultrasonic tomography results.
Results: (1) The prevalence of NAFL in type 2 diabetic patients was 42.1%. Among the patients younger than 50 years old, the prevalence of NAFL in males was higher than that in females. However, among the patients older than 50 years old, the case was just the opposite, higher in females. (2) The prevalences of overweight/obesity, dyslipidemia, hypertension, and metabolic syndrome (MS) of NAFL group were 59.4%, 66.4%, 57.7% and 71.7% respectively, all significantly higher than those of control group (P < 0.01). The risk for NAFL paralled with the increment of number of components of MS. Those patients with four components of MS had higher risk of NAFL than those patients with isolated type 2 diabetes (OR = 11.1 and 10.6, both P < 0.001). (3) The body mass index, diastolic blood pressure, fasting plasma glucose, hemoglobin A(1)c, total cholesterol, triglyceride, C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase, the level of serum uric acid and C-peptide of NAFL group were all higher than those of control group (P < 0.05 - 0.01). The level of serum high density lipoprotein-cholesterol and the AST/ALT rate were lower than those of control group (P < 0.05 - 0.01). Triglyceride, body mass index, CRP, the level of postprandial C-peptide at 30 min and fasting plasma glucose were the risk factors of NAFL. (4) The incidence of type 2 diabetic patients with increased CRP levels were 29.1% in male and 33.8% in female. patients with increased CRP levels had higher incidence of NAFL (54.4% vs 35.3% in male, 62.0% vs 38.4% in female, both P < 0.01).
Conclusions: (1) About 2/5 of in-patients with type 2 diabetes had NAFL, and NAFL was closely associated with MS. (2) The increased level of CRP, as well as obesity, hyperglycemia, dyslipidemia and the increased level of postprandial C-peptide might increase the risk of NAFL in the patients with type 2 diabetes.