P1024INFLUENCE OF NON-ALCOHOLIC FATTY LIVER DISEASE IN THE EVOLUTION OF RENAL FUNCTION IN DIABETIC PATIENTS

Abstract Background and Aims Nowadays, there is growing evidence that non-alcoholic fatty liver disease (NAFLD) may be associated with renal impairment and have an impact on the evolution of renal function in patients with type 2 diabetes mellitus (DM). Our aim was to compare the effect on renal function and proteinuria in patients with type 2 DM according to the presence of NAFLD. Method Retrospective and observational study, including patients with type 2 DM, < 70 years of age and with estimated glomerular filtration rate (eGFR) > 30 ml/min/1,73 m2. NAFLD was defined with the presence of compatible ultrasonography and/or presence of fibrosis using NAFLD score. Metabolic syndrome (MSd) was defined as: obesity (body mass index (BMI) > 30 kg/m2), hypertension and dyslipidaemia. Patients were classified according to the presence or absence of NAFLD. We analysed different clinical and analytical variables along the follow up. Results A total of 71 patients were included (66% males) with mean age of 57.4 ± 7.8 years. The median evolution of type 2 DM was 72.2 months (34.7 - 125.5 months) and 90.1% of the patients were treated with renin-angiotensin blockade. When comparing patients with (group 1, n=38) and without (group 2, n=33) NAFLD at the beginning of this study, we found no significant difference in eGFR (80.2 ± 40.4 ml/min vs 71.4 ± 31.8 ml/min), proteinuria (1.4 ± 2.7 g/24h vs 0.8 ± 1.0 g/24h) and glycated haemoglobin (6.8 ± 1.4% vs 7.2 ± 1.6%). On the other hand, we found significant difference in the presence of higher BMI (33.8 vs 29.3 kg/m2; .001) and presence of MSd (67.7 vs 32.3%; .03) in those patients with NAFLD. After a mean follow-up time of 74 months, we found significant differences in the loss of eFGR (-33.8 vs -13.9 ml/min; .003), but no difference in increase of proteinuria. We found an increase in incidence of chronic kidney disease in group 1 (50%) vs group 2 (10.5%). There were no differences in the need to initiate renal replacement therapy or all-cause mortality. Conclusion NAFLD in type 2 DM caused a mayor decline in renal function. We should, therefore, take into consideration the presence of NALFD and the presence of MSd to optimise treatment of associated risk factors.

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Hepatic steatosis and non-alcoholic fatty liver disease are not associated with decline in renal function in people with Type 2 diabetes

Diabetic Medicine ◽

10.1111/dme.12456 ◽

2014 ◽

Vol 31 (9) ◽

pp. 1039-1046 ◽

Cited By ~ 10

Author(s):

S. J. Jenks ◽

B. R. Conway ◽

T. J. Hor ◽

R. M. Williamson ◽

S. McLachlan ◽

...

Keyword(s):

Type 2 Diabetes ◽

Renal Function ◽

Liver Disease ◽

Fatty Liver ◽

Hepatic Steatosis ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Non-alcoholic fatty liver disease, cytokeratin-18, and risk of type 2 diabetes mellitus: A cohort study

10.21203/rs.2.16214/v1 ◽

2019 ◽

Author(s):

Ruofan Hu ◽

Shaoyong Xu ◽

Han Shen ◽

Ce Jing ◽

Aihua Jia ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cohort Study ◽

Fatty Liver Disease ◽

Cytokeratin 18 ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Abstract Background & Aims: Although many studies have shown that non-alcoholic fatty liver disease (NAFLD) is associated with type 2 diabetes mellitus (T2DM), no cohort study has explored the relationship between the histopathological grade of NAFLD and the risk of T2DM in NAFLD patients. We aimed to explore whether a higher concentration of cytokeratin-18 (CK-18), as a reliable marker of hepatic fibrosis, was associated with a greater risk of T2DM in patients with NAFLD. Methods: The population-based cohort study was based on China National Diabetes and Metabolic Disorders Survey with a follow-up of five years. NAFLD was determined by ultrasonography. T2DM were diagnosed based on oral glucose tolerance test. Serum CK-8 was measured using the M30 Apoptosense ELISA kit. Results: 457 subjects were enrolled and three groups were analyzed: a non-NAFLD group (n=363), a low-CK-18 NAFLD group (n=46), and a high-CK-18 NAFLD group (n=48). 20 (3.9%) developed diabetes during follow-up. The incidence of T2DM was 2.5%, 8.7%, and 12.5% in the non-NAFLD, low-CK-18 NAFLD, and high-CK-18 NAFLD groups, respectively. Cox proportional hazard regression showed that, compared with the non-NAFLD group, the adjusted relative risks of T2DM were 3.37 (95% CI: 1.05-10.86, P =0.042) and 4.71 (95% CI: 1.71-12.99, P =0.003), respectively, in the low-CK-18 NAFLD and high-CK-18 NAFLD groups. Conclusions: Higher CK-18 level in ultrasound-diagnosed NAFLD patients is associated with higher risk of T2DM. We recommend screening for NAFLD using ultrasound in the first instance, with, if possible, CK-18 assay being subsequently used to screen individuals at higher risk of diabetes.

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Search for a way to improve the serum albumin binding function and the functional state of the liver when hypertension combined with non-alcoholic fatty liver disease

Journal of Education, Health and Sport ◽

10.12775/jehs.2022.12.01.005 ◽

2022 ◽

Vol 12 (1) ◽

pp. 55-64

Author(s):

Yurii Dzordzo ◽

Serhiy Andreychyn

Keyword(s):

Functional State ◽

Protein Metabolism ◽

Fatty Liver Disease ◽

Albumin Binding ◽

Alcoholic Fatty Liver ◽

Binding Function ◽

Group 2 ◽

Positive Effect ◽

Alcoholic Fatty Liver Disease ◽

Group 1

Recently, there has been a significant increase in interest in research on hypertension (HT), primarily due to its high prevalence. The interest in studying this problem is also exacerbated by the often insufficient effectiveness of existing treatments. The effect of concomitant pathologies on HT, in particular non-alcoholic fatty liver disease (NAFLD), remains poorly understood. The aim of the study – to evaluate the changes in the serum albumin binding function (SABF) and its relationship with the biochemical parameters of the blood when HT and HT combined with NAFLD and to suggest ways of medical correction of the detected disorders. Material and methods. 76 individuals with stage 2 HT with degree 2–3 arterial hypertension were examined. They were divided into two groups. Group 1 included 28 patients with HT without concomitant diseases who received basic hypertension therapy, and group 2 included patients with concomitant NAFLD. The latter in turn was divided into two subgroups: 2a – 27 patients who in addition to basic HT therapy received additional Antral hepatoprotector 200 mg three times a day for 2 months, and 2b – 21 patients who received only basic HT therapy. All of them underwent a standard clinical examination, as well as SABF, protein fractions, and liver function indicators. The comparison group consisted of 25 healthy individuals, comparable in age and sex. Results and Discussion. Patients in group 1 showed moderate changes in the functional state of the liver, but they did not exceed the norm, patients in group 2 – a significant decrease in SABF, as well as protein metabolism (decrease in total protein, albumin, albumin-globulin ratio and increase globulins) and liver function (increased activity of aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltranspeptidase, thymol levels, alkaline phosphatase and total bilirubin). After treatment, the majority of patients in subgroup 2 had a statistically significant increase in SABF and a quantitative improvement in protein fractions and functional state of the liver. In subgroup 2-b, where hepatoprotective treatment was not performed, significant changes in most indicators did not occur. The results may be related to the positive effect of the drug on the liver, which leads to improved functional status of hepatocytes and their protein-synthesizing ability. In subgroup 2 b, where hepatoprotective treatment was not performed, significant changes in most indicators did not occur. The results may be related to the positive effect of the drug on the liver leading to improved functional status of hepatocytes and their protein-synthesizing ability. Conclusions. Changes of the functional state of the liver are observed when HT without concomitant pathology. HT with NAFLD is accompanied by a significant decrease in SABF, changes in protein metabolism and the functional state of the liver. Prescribing Antral to such patients helps to increase SABF, normalize protein metabolism and improve the functional state of the liver.

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1336 NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) INDEPENDENTLY PREDICTS TYPE-2 DIABETES AND PRE-DIABETES DURING A SEVEN-YEAR PROSPECTIVE FOLLOW-UP

Journal of Hepatology ◽

10.1016/s0168-8278(12)61347-6 ◽

2012 ◽

Vol 56 ◽

pp. S526

Author(s):

S. Zelber-Sagi ◽

R. Lotan ◽

O. Shibolet ◽

M. Webb ◽

A. Buch ◽

...

Keyword(s):

Type 2 Diabetes ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Impact of Non-Alcoholic Fatty Liver Disease on Metabolic Comorbidities in Type 2 Diabetes Mellitus

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/a-1378-4679 ◽

2021 ◽

Author(s):

Christian Labenz ◽

Karel Kostev ◽

Saleh A. Alqahtani ◽

Peter R. Galle ◽

Jörn M. Schattenberg

Keyword(s):

Myocardial Infarction ◽

Type 2 Diabetes ◽

Liver Disease ◽

High Risk ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Metabolic Comorbidities ◽

Alcoholic Fatty Liver Disease

Abstract Objective Type 2 Diabetes (T2D) is a major risk factor for the development and progression of non-alcoholic fatty liver disease (NAFLD). The published prevelance in epidemiological studies in this high risk population exceeds 70%. The aim of this analysis was to investigate the impact of NAFLD on T2D patients in Germany. Methods Using the Disease Analyzer Database (IQVIA), T2D patients with NAFLD diagnosed in Germany were matched to a cohort without NAFLD controlling for age, sex, physician, index year and metabolic comorbidities and assessed for their risk of developing myocardial infarction, stroke, peripheral arterial disease (PAD) or chronic kidney disease, as well as the type of T2D treatment on NAFLD. Results 2633 T2D patients with NAFLD were matched to 2633 T2D patients without liver disease. The ICD coded prevalence of NAFLD in patients with T2D in primary care in Germany was 7.8%. On regression analysis of patients with T2D , the presence of NAFLD was associated with a higher risk of renal failure during follow-up (HR 1.17, 95% CI 1.02–1.34, p=0.027). No association with the development of myocardial infarction, stroke, PAD or initiation of insulin therapy was observed. NAFLD patients were more frequently treated with DDP-4 inhibitors (+/-metformin) and less frequently with insulin within the first year of T2D diagnosis. The metabolic control (HbA1c range 6.5–7.5%) during follow-up did not differ between both groups. Conclusion The coded prevalence of NAFLD in T2D patients is low, which is in contrast to published series. Enhancing disease awareness of NAFLD and screening recommendations in high risk populations will be beneficial for the active management of these patients.

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The effect of non-alcoholic fatty liver disease on the functional state of the kidneys in patients with chronic heart failure

Experimental and Clinical Gastroenterology ◽

10.31146/1682-8658-ecg-194-10-35-42 ◽

2021 ◽

pp. 35-42

Author(s):

M. E. Statsenko ◽

S. V. Turkina ◽

S. V. Fabritskaya ◽

N. N. Shilina ◽

M. N. Titarenko ◽

...

Keyword(s):

Heart Failure ◽

Insulin Resistance ◽

Liver Disease ◽

Chronic Heart Failure ◽

Functional State ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Group 2 ◽

Alcoholic Fatty Liver Disease ◽

Group 1

Aim: to study the functional state of the kidneys in patients with chronic heart failure (CHF) and non-alcoholic fatty liver disease (NAFLD).Materials and methods. 144 patients with CHF aged 45-70 years were divided into two groups: group 1 — persons with CHF and NAFLD, group 2 — CHF without NAFLD. A clinical examination was performed, the indices of FLI steatosis and NFS liver fibrosis were calculated, the functional state of the kidneys and the adipokine status were evaluated.Results. The main group of patients with CHF and NAFLD is mainly represented by people with grade I obesity (73 (84%) vs 5 (9%), p<0.05). Among patients with CHF and NAFLD, a clinically significant decrease in GFR<60 ml/min/1.73 m2 was significantly more often detected compared to patients with CHF without NAFLD (37% vs 21% in groups 1 and 2, respectively). The level of albuminuria was significantly higher in the group of patients with CHF and NAFLD (200.7±22.3 [54.7;390] vs 92.6±23.4 [10.2;188.7] mg/g in groups 1 and 2, respectively). The percentage of individuals with an AU/CR. urine ratio >30 mg/g was statistically significantly higher in group 1 compared to group 2 (82.1 vs 51.1% in groups 1 and 2, respectively). The level of serum leptin was significantly higher and the concentration of serum adiponectin was significantly lower compared to group 2 in the main group of patients with CHF and NAFLD compared to the control group. There was a significantly higher occurrence of insulin resistance in patients with CHF and NAFLD. Correlation analysis revealed the presence of statistically significant associations between the parameters characterizing the functional state of the kidneys and the indices of FLI, NFD, adipokines, and the severity of insulin resistance.Conclusion. In patients with CHF and NAFLD, a significant deterioration in the functional state of the kidneys was found, in comparison with patients with “isolated” CHF with comparable FC.

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Effect of Empagliflozin on Liver Function in type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Trials

10.21203/rs.3.rs-100920/v1 ◽

2020 ◽

Author(s):

Davoud Roostaei

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Liver Disease ◽

Fatty Liver Disease ◽

Liver Fat ◽

Alcoholic Fatty Liver ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

Abstract Background Many reports are indicating the blood sugar-lowering potential of Empagliflozin in type 2 diabetes mellitus and its anti-lipogenesis effects in the liver, as studied in mice models; while few clinical trials have evaluated its effect on liver fat content and liver function. Objectives This study aimed to evaluate the effect of Empagliflozin on the treatment of non‐alcoholic fatty liver disease in type 2 diabetes mellitus patients.Search methods Scopus, Cochran Library, PubMed, and Web of Science databases were searched from 1990 to 2020 together with reference checking and citation searching to identify additional studies. Selection criteria Inclusion criteria for studies were the evaluation of patients with non‐alcoholic fatty liver disease and type 2 diabetes being treated with Empagliflozin for 24 weeks. Our interest outcomes were Liver fat, ALT, and AST. Data analysis Random effect size model was used for pooling data to calculate mean differences in RevMan Version 5.3. I2 was used to evaluate heterogeneity. Results Three clinical trial studies were included with 2344 patients. In pooled ALT ‎mean difference evaluation within 24 weeks of studies, there was a significant ‎difference between subjects receiving Empagliflozin versus controls (MD=-6.6 ‎CI95%(-10.27 to -3.73; P=0.06; I2=99%). ‎ In case of AST (MD=-9.06 CI95% (-20.45 to 2.34; P=0.12; I2=98%) and Liver fat (MD=-4.46 CI95% (-10.06 to 0.77; P=0.09; I2=98%), ‎there was not any significant difference between subjects receiving Empagliflozin ‎versus controls. Conclusion While Empagliflozin seems to be effective in lowering ALT levels; further studies are needed to confirm its efficacy in lowering liver fat.

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Testosterone deficiency and non-alcoholic fatty liver disease in men with type 2 diabetes mellitus

Diabetes Mellitus ◽

10.14341/dm10232 ◽

2020 ◽

Vol 22 (6) ◽

pp. 542-549 ◽

Cited By ~ 1

Author(s):

Irina A. Khripun ◽

Sergey V. Vorobyev ◽

Yanina Allahverdieva

Keyword(s):

Diabetes Mellitus ◽

Liver Disease ◽

Fatty Liver Disease ◽

Liver Fat ◽

Alcoholic Fatty Liver ◽

Type 2 Dm ◽

Carbohydrate And Lipid Metabolism ◽

Fat Fraction ◽

Alcoholic Fatty Liver Disease

BACKGROUND: Current studies investigated diseases associated with testosterone (T) deficiency; however, data on the combination of non-alcoholic fatty liver disease (NAFLD) with hypogonadism and diabetes mellitus (DM) in men are extremely limited. AIMS: To evaluate the effects of hypogonadism on the formation and progression of NAFLD in men with type 2 DM. METHODS: The study included 90 men with type 2 DM [age 54 (4957) years]. Patients underwent clinical examinations, biochemical analysis (alanine aminotransferase (ALT), aspartate aminotransferase, gamma-glutamyl transpeptidase (GGTP), fasting glucose, immunoreactive insulin, HOMA index, HbA1c, lipid profile), immune enzyme analysis (luteinising hormone, total T, sex hormone binding globulin, resistin, adiponectin, leptin) and magnetic resonance imaging with liver fat fraction determination were performed. Patients were divided into two groups: 132 eugonadal patients and 258 men with newly diagnosed hypogonadism. RESULTS: Increased insulin resistance, hyperinsulinemia, hypertriglyceridemia were observed in men with hypogonadism compared to eugonadal patients. Along with biochemical signs of impaired liver function, such as an increase in liver enzyme concentrations of ALT by 24.5% (p = 0.02), GGTP by 60.5% (p = 0.001), de Rytis coefficient by 60.4% (p = 0.047), of men in the 2nd group, the liver fat fraction also increased, which together indicates NAFLD progression. The proton density of the liver fat fraction according to MRI was 4.12 [2.255.30] % in the 1st group and 10.30 [7.78; 14.44] % in the 2nd group (p=0.001). This was accompanied by an increase in fat production of resistin by 2 times and leptin by 12 times (p 0.001) in patients of group 2 compared to 1. CONCLUSIONS: The combination of type 2 DM with hypogonadism in men leads not only to deterioration of carbohydrate and lipid metabolism but also to disturbance of liver function: increased ALT, GGTP concentrations and liver fat. Increased secretion of leptin and resistin in the adipose tissue is assumed to be a pathogenetically associated with the development of carbohydrate and lipid metabolism disorders, NAFLD and T deficiency.

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Modulation of Fibroblast Growth Factor-21 and βklotho Proteins Expression in Type 2 Diabetic Women with Non-alcoholic Fatty Liver Disease Following Endurance and Strength Training

Hepatitis Monthly ◽

10.5812/hepatmon.116513 ◽

2021 ◽

Vol 21 (7) ◽

Author(s):

Afsaneh Astinchap ◽

Amirabbas Monazzami ◽

Khadijeh Fereidoonfara ◽

Zohreh Rahimi ◽

Mehrali Rahimi

Keyword(s):

Resistance Training ◽

Fatty Liver Disease ◽

Moderate Intensity ◽

Fibroblast Growth Factor 21 ◽

Fibroblast Growth ◽

Alcoholic Fatty Liver ◽

Training Groups ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

Background: There is limited research on the effects of physical activity with moderate intensity on βklotho (BKL) and fibroblast growth factor-21 (FGF-21) proteins expression in diabetic patients with non-alcoholic fatty liver disease (NAFLD). Objectives: This study was aimed to determine the effects of eight weeks of endurance and resistance training on BKL and FGF-21 proteins expression in diabetic women with NAFLD. Methods: Forty-five diabetic women (age: 51 ± 8 years, height: 158 ± 2 cm, weight: 75 ± 8 kg) with NAFLD participated. The subjects were randomly divided into three groups, including control (n = 15), endurance training (n = 15), and resistance training (n = 15). The enzyme-linked immunosorbent assay (ELISA) was used to measure BKL and FGF-21 proteins. Two-way ANOVA with repeated measures was applied to determine differences at a significant level of P < 0.05. Results: Eight weeks of endurance and resistance training reduced AST, ALT, and FGF-21 (25, 26, 19% and 13, 16, 13%, respectively) and increased BKL (16% and 18, respectively). However, in the variables of HDL, insulin, AST, ALT, FGF-21, and BKL, a significant difference was observed in the control group (P < 0.05). Also, there was a significant difference between the control and training groups in BKL and FGF21 proteins expression (P < 0.05), but no significant difference was observed between the two training groups (P > 0.05). Conclusions: The results suggest that both moderate-intensity endurance and resistance training can modulate the destructive effects of type 2 diabetes and NAFLD on BKL and FGF-21 proteins expression, and there is no difference between the two training methods.

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