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

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.

scholarly journals Elevated serum cytokeratin-18 concentration in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease

2018 ◽  
Vol 56 (1) ◽  
pp. 141-147 ◽  
Author(s):  
Yu-Hung Chang ◽  
Hsien-Chang Lin ◽  
Der-Wei Hwu ◽  
Dao-Ming Chang ◽  
Kun-Chen Lin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cytokeratin 18 ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Background Serum cytokeratin-18 is believed to be a marker of hepatic cell damage. However, few studies have discussed about the serum cytokeratin-18 concentration in type 2 diabetes mellitus patients and investigated its association with non-alcoholic fatty liver disease as well as metabolic biomarkers. Methods Healthy participants and type 2 diabetes mellitus patients were enrolled. Physical and metabolic factors were recorded, and non-alcoholic fatty liver disease was screened by abdominal ultrasound and the fatty liver index. The cytokeratin-18 concentration was detected using two commercially available immunoassay kits (M30 and M65 ELISA kit, Previa AB, Sweden). Results Overall, 22.8% (29/127) and 35.9% (42/117) of the participants were diagnosed with non-alcoholic fatty liver disease in the non-diabetes mellitus group and type 2 diabetes mellitus group, respectively. In the non-diabetes mellitus group and type 2 diabetes mellitus group, our result showed that participants with non-alcoholic fatty liver disease had a higher serum cytokeratin-18 M30 and cytokeratin-18 M65 concentration as compared with participants without non-alcoholic fatty liver disease. Interestingly, as compared with healthy participants without non-alcoholic fatty liver disease, our result also demonstrated that type 2 diabetes mellitus patients without non-alcoholic fatty liver disease had a higher serum cytokeratin-18 M30 (108.4 ± 66.2 vs. 87.1 ± 34.6 U/L; P = 0.038) and cytokeratin-18 M65 concentration (285.4 ± 115.3 vs. 248.5 ± 111.3 U/L; P = 0.031). The independent relationship between type 2 diabetes mellitus and cytokeratin-18 was further strengthened by the significant positive association between fasting plasma glucose and serum cytokeratin-18 concentration via multivariate regression analyses (cytokeratin-18 M30: β = 0.034, P = 0.029; cytokeratin-18 M65: β = 0.044, P = 0.002). Conclusions Independent of non-alcoholic fatty liver disease, our results suggested that the cytokeratin-18 concentration is closely associated with the hyperglycaemic milieu. The association between serum cytokeratin-18 and type 2 diabetes mellitus may be worthy of further investigation.

scholarly journals Effect of sodium-glucose cotransporter 2 inhibitor in patients with non-alcoholic fatty liver disease and type 2 diabetes mellitus: a propensity score-matched analysis of real-world data

2021 ◽  
Vol 12 ◽  
pp. 204201882110002
Author(s):  
Taeang Arai ◽  
Masanori Atsukawa ◽  
Akihito Tsubota ◽  
Shigeru Mikami ◽  
Hiroki Ono ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Propensity Score ◽  
Fatty Liver Disease ◽  
Liver Inflammation ◽  
Alcoholic Fatty Liver ◽  
Sodium Glucose Cotransporter ◽  
Alcoholic Fatty Liver Disease

Background: Although sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) improve not only glycemic control but also liver inflammation and fatty changes in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM), its sustainability and effect on liver fibrosis have remained unclear. The current study aimed to clarify the effects of 48-week SGLT2-I therapy on liver inflammation, fatty changes, and fibrosis in NAFLD patients with T2DM. Methods: This study evaluated the effects of SGLT2-I on NAFLD, including liver fibrosis assessed via transient elastography, in 56 patients with NAFLD who received SGLT2-I for 48 weeks. Moreover, changes in each clinical parameter between patients receiving SGLT2-I (the SGLT2-I group) and those receiving other oral hypoglycemic agents (OHAs) (the non-SGLT2-I group) were compared, using 1:1 propensity score matching to adjust for baseline factors. Results: The SGLT2-I group exhibited a significant decrease in controlled attenuation parameter (312 dB/m at baseline to 280 dB/m at week 48) and liver stiffness measurement (9.1–6.7 kPa) ( p < 0.001 for both). After propensity score matching (44 patients each in the SGLT2-I and non-SGLT2-I groups), no significant difference in HbA1c decrease was observed between the two groups. However, compared with the non-SGLT2-I group, the SGLT2-I group showed a significant decrease in body weight ( p < 0.001), alanine aminotransferase ( p = 0.02), uric acid ( p < 0.001), and Fibrosis-4 (FIB-4) index ( p = 0.01) at week 48. The improvement in FIB-4 index, defined as a ⩾10% decline from baseline at week 48, was 56.8% (25/44) in the SGLT2-I group and 20.5% (9/44) in the non-SGLT2-I group ( p < 0.001). Conclusion: SGLT2-Is improved not only glycemic control but also liver fatty infiltration and fibrosis in patients with NAFLD and T2DM, suggesting their possible superiority to other OHAs concerning these effects.

scholarly journals Non-Alcoholic Fatty Liver Disease among Type-2 Diabetes Mellitus Patients in Abha City, South Western Saudi Arabia

2018 ◽  
Vol 15 (11) ◽  
pp. 2521 ◽  
Author(s):  
Abdullah Alsabaani ◽  
Ahmed Mahfouz ◽  
Nabil Awadalla ◽  
Mustafa Musa ◽  
Suliman Al Humayed
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Dietary Control ◽  
Alcoholic Fatty Liver ◽  
Factors Associated ◽  
Alcoholic Fatty Liver Disease

The objective of this study was to determine the prevalence and the factors associated with non-alcoholic fatty liver disease (NAFLD) among type-2 diabetes mellitus (T2DM) patients in Abha City, Southwestern Saudi Arabia. Using a cross-sectional study design, a representative sample of 245 T2DM patients were recruited from all primary healthcare centers in Abha city. A detailed medical history as well as laboratory investigations were done. NAFLD was diagnosed using abdominal ultrasound examination. The overall prevalence of NAFLD was 72.8% (95% CI: 66.6%–78.1%). In a multivariable regression analysis, the risk of NAFLD was significantly higher among overweight T2DM patients (aOR = 6.112, 95% CI: 1.529–4.432), Obese (aOR = 10.455, 95% CI: 2.645–41.326), with high ALT of more than 12 IU/L (aOR = 2.335, 95% CI: 1.096–5.062), moderate diet-compliant patients (aOR = 2.413, 95% CI: 1.003–5.805) and poor diet-compliant patients (aOR = 6.562, 95% CI: 2.056–20.967). On the other hand, high HDL (high density cholesterol) (in mg/dL) was a protective factor for NAFLD (aOR = 0.044, 95% CI: 0.005–0.365). It was concluded that NAFLD is a common association of T2DM. Increasing BMI (Body mass index), lower HDL level, and poor dietary control are significant factors associated with NAFLD among T2DM patients. Health education to improve dietary control and avoid excessive weight gain, testing for NAFLD among diabetic patients, especially those with abnormal BMI and HDL, are recommended for early detection and to ensure optimal levels of HDL.

scholarly journals Elevated Liver Enzymes in Patients with Type 2 Diabetes Mellitus and Non-alcoholic Fatty Liver Disease

Cureus ◽  
2018 ◽  
Author(s):  
Amrendra Mandal ◽  
Bikash Bhattarai ◽  
Paritosh Kafle ◽  
Mazin Khalid ◽  
Saikiran K Jonnadula ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Enzymes ◽  
Alcoholic Fatty Liver ◽  
Elevated Liver Enzymes ◽  
Alcoholic Fatty Liver Disease

scholarly journals Efficacy of liraglutide in treating type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease

2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Feng Tian ◽  
Zhigang Zheng ◽  
Damin Zhang ◽  
Si He ◽  
Jie Shen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
C Reactive Protein ◽  
Alcoholic Fatty Liver ◽  
Reactive Protein ◽  
Alcoholic Fatty Liver Disease

Type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD) is difficult to treat. The present study explored the efficacy of (liraglutide) Lira in treating T2DM complicated with NAFLD. A total of 127 patients suffering from T2DM complicated with NAFLD were enrolled in the present study, and randomly assigned to a Lira group (liraglutide injection: 0.6–1.2 mg/day, 12 weeks, n=52) or a Metformin (Met) group (oral metformin: 1000–1500 mg/day, 12 weeks, n=75). During the treatment phase, the values for fasting plasma glucose (FPG), 2 h plasma glucose (2hPG), glycated hemoglobin (HbA1c), aspartate aminotransferase (AST)/alanine aminotransferase (ALT), and adiponectin (APN) decreased in both the Lira and Met groups, and the levels of Δ2hPG, ΔAST/ALT, and ΔAPN in the Lira group were significantly lower than those in the Met group. The values for total cholesterol (TC), triglycerides (TG), low-and high-density lipoproteins (LDL and HDL), ALT, AST, weight, body mass index (BMI), waist to hip ratio (WHR), and C-reactive protein were markedly increased in both groups, and levels of ΔAST, ΔALT, Δweight, ΔBMI, ΔWHR, and ΔCRP (C-reactive protein) in the Lira group were significantly higher than those in the Met group. An analysis of treatment efficacy showed that liraglutide was better than metformin in its ability to significantly decrease the ALT levels in patients with combined T2DM and NAFLD. Furthermore, liraglutide was more effective than metformin at ameliorating the severity of T2DM complicated with NAFLD, and produced its effects by alleviating liver inflammation and improving liver function.

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