The Determinants of Liver Fibrosis in Patients with Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus

Chia-Yen Dai; Tzu-Jung Fang; Wei-Wen Hung; Hui-Ju Tsai; Yi-Chun Tsai

doi:10.3390/biomedicines10071487

The Determinants of Liver Fibrosis in Patients with Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus

Biomedicines. 2022 Jun 23;10(7):1487. doi: 10.3390/biomedicines10071487.

Authors

Chia-Yen Dai^{1

2}, Tzu-Jung Fang³, Wei-Wen Hung⁴, Hui-Ju Tsai^{2

5

6}, Yi-Chun Tsai^{2

7

8

9

10}

Affiliations

¹ Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
² School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
³ Division of Geriatrics and Gerontology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
⁴ Division of Endocrinology and Metabolism, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
⁵ Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan.
⁶ Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁷ Division of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
⁸ Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
⁹ Liquid Biopsy and Cohort Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
¹⁰ Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

Abstract

Liver fibrosis is a key pathophysiology process in chronic liver disease. It is still unclear whether the impact of liver fibrosis is not fully realized in type 2 diabetes mellitus (T2D) patients with nonalcoholic fatty liver disease (NAFLD), and the factors affecting nonalcoholic steatohepatitis (NASH) or liver stiffness also remain unclear. The aim of this study was to evaluate the determinants of liver fibrosis and in T2D patients with NAFLD. Liver fibrosis and steatosis were measured using transient elastography (FibroScan). Of 226 T2D patients with NAFLD, 50 with liver fibrosis had higher body mass index, serum uric acid, triglyceride and glycated hemoglobin levels and lower high density lipoprotein levels than 176 without liver fibrosis. Multivariate analysis revealed that aging, obesity, sulfonylurea usage and high levels of AST increased the risk of liver fibrosis in T2D patients with NAFLD. Our findings provide useful information to clinical physicians for earlier detection of liver fibrosis in T2D patients with NAFLD and to prevent liver fibrosis through controlling these risk factors.

Keywords: NAFLD; fibroscan; liver fibrosis; type 2 diabetes mellitus.

Grants and funding

This study was funded by grants from Ministry of Science and Technology (MOST 110-2314-B-037-056-), Kaohsiung Municipal Ta-Tung Hospital (KMTTH-110-R006), and National Pingtung University of Science and Technology and Kaohsiung Medical University (NPUST kmU-111-P009). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.