Association of Nonalcoholic Fatty Liver Disease (NAFLD) with Peripheral Diabetic Polyneuropathy: A Systematic Review and Meta-Analysis

Aims. The relationship between nonalcoholic fatty liver disease (NAFLD) and diabetic polyneuropathy (DPN) has been demonstrated in many studies, although results were conflicting. This meta-analysis aims to summarize available data and to estimate the DPN risk among NAFLD patients. Materials and methods. We performed a comprehensive literature review until 4 June 2021. Clinical trials analyzing the association between NAFLD and DPN were included. Results. Thirteen studies (9614 participants) were included. DPN prevalence was significantly higher in patients with NALFD, compared to patients without NAFLD (OR (95%CI) 2.48 (1.42–4.34), p = 0.001; I2 96%). This finding was confirmed in type 2 diabetes (OR (95%CI) 2.51 (1.33–4.74), p = 0.005; I2 97%), but not in type 1 diabetes (OR (95%CI) 2.44 (0.85–6.99), p = 0.100; I2 77%). Also, body mass index and diabetes duration were higher in NAFLD subjects compared to those without NAFLD (p < 0.001), considering both type 2 and type 1 diabetes. Conclusion. Despite a high heterogeneity among studies, a significantly increased DPN prevalence among type 2 diabetes subjects with NAFLD was observed. This result was not found in type 1 diabetes, probably due to the longer duration of disease. Physicians should pay more attention to the early detection of DPN, especially in patients with NAFLD.

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Systematic Review with Meta-Analysis: Response to Pioglitazone in Patients with Nonalcoholic Fatty Liver Disease with or Without Type 2 Diabetes

SSRN Electronic Journal ◽

10.2139/ssrn.3728783 ◽

2020 ◽

Author(s):

Zeyu Wang ◽

Huiqing Du ◽

Cuihua Ma ◽

Hongyu Chen ◽

Yong Jiang

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Meta Analysis ◽

Nonalcoholic Fatty Liver

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A Meta-Analysis of the Effects of Glucagon-Like-Peptide 1 Receptor Agonist (GLP1-RA) in Nonalcoholic Fatty Liver Disease (NAFLD) With Type 2 Diabetes (T2D)

10.21203/rs.3.rs-517581/v1 ◽

2021 ◽

Author(s):

Samit Ghosal ◽

Debasis Datta ◽

Binayak Sinha

Keyword(s):

Type 2 Diabetes ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Receptor Agonist ◽

Meta Analysis ◽

Nonalcoholic Fatty Liver ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

Abstract Introduction: Treatment options for nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D), two conditions which coexist, are limited though weight loss is an important strategy to improve outcomes in either disease. Glucagon-like peptide 1 receptor agonist (GLP1-RA) present a novel option to treat this dual disease by their salutary effects on glycaemic control and weight reduction.Methods: Eight randomized controlled trials on T2D and NAFLD from the Cochrane Library, Embase, and PubMed were included in this meta-analysis. The Comprehensive Meta-Analysis Software version 3 was used to calculate the effect size.Result: In a pooled population of 615 patients—297 on GLP1-RA and 318 in the control arm, GLP1-RA produced a significant improvement in alanine aminotransferase [standardised mean difference (SDM), -0.56, 95%CI, - 0.88 to -0.25, P<0.01], aspartate aminotransferase (SDM, -0.44, SE, 95%CI, -0.64 to -0.24, P<0.01), gamma glutaryl transaminase (SDM, -0.59, 95%CI, -0.86 to -0.34, P<0.01) and reduction in liver fat content (LFC) (SDM, -0.43, 95%CI, - 0.74 to -0.13, P<0.01), as well as glycosylated haemoglobin (SDM, -0.40, 95% CI, -0.61 to -0.19, P<0.01) and weight (SDM, -0.66, 95% CI, -0.88 to -0.45, P<0.01), in comparison to standard of care or placebo. Significant improvement in biopsy resolution was also seen in the GLP1-RA arm (Rate Ratio, 6.59, 95%CI, 2.67 to 16.29, P<0.01). Conclusion: This is possibly the first meta-analysis conducted exclusively in patients with T2D and NAFLD which presents a strong signal that GLP1-RA, improve liver function and histology by improving glycaemia, reducie body weight and hepatic fat, which in turn reduces hepatic inflammation.Trial Registration: PROSPERO (ID: CRD42021228824)

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Non-alcoholic fatty liver disease (NAFLD) prevalence and its metabolic associations in patients with type 1 diabetes and type 2 diabetes

Diabetes Obesity and Metabolism ◽

10.1111/dom.12973 ◽

2017 ◽

Vol 19 (11) ◽

pp. 1630-1634 ◽

Cited By ~ 53

Author(s):

Kenneth Cusi ◽

Arun J. Sanyal ◽

Shuyu Zhang ◽

Mark L. Hartman ◽

Juliana M. Bue-Valleskey ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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A meta-analysis of the effects of glucagon-like-peptide 1 receptor agonist (GLP1-RA) in nonalcoholic fatty liver disease (NAFLD) with type 2 diabetes (T2D)

Scientific Reports ◽

10.1038/s41598-021-01663-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Samit Ghosal ◽

Debasis Datta ◽

Binayak Sinha

Keyword(s):

Type 2 Diabetes ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Receptor Agonist ◽

Meta Analysis ◽

Nonalcoholic Fatty Liver ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

AbstractTreatment options for nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D), two conditions which coexist, are limited though weight loss is an important strategy to improve outcomes in either disease. Glucagon-like peptide 1 receptor agonist (GLP1-RA) present a novel option to treat this dual disease by their salutary effects on glycaemic control and weight reduction. Eight randomized controlled trials on T2D and NAFLD from the Cochrane Library, Embase, and PubMed were included in this meta-analysis. The Comprehensive Meta-Analysis Software version 3 was used to calculate the effect size. In a pooled population of 615 patients—297 on GLP1-RA and 318 in the control arm, GLP1-RA produced a significant improvement in alanine aminotransferase [standardised mean difference (SDM), − 0.56, 95% CI − 0.88 to − 0.25, P < 0.01], aspartate aminotransferase (SDM, − 0.44, SE, 95% CI − 0.64 to − 0.24, P < 0.01), gamma glutaryl transaminase (SDM, − 0.60, 95% CI − 0.86 to − 0.34, P < 0.01) and reduction in liver fat content (LFC) (SDM, − 0.43, 95% CI − 0.74 to − 0.12, P < 0.01), as well as glycosylated haemoglobin (SDM, − 0.40, 95% CI, − 0.61 to − 0.19, P < 0.01) and weight (SDM, − 0.66, 95% CI, − 0.88 to − 0.44, P < 0.01), in comparison to standard of care or placebo. Significant improvement in biopsy resolution was also seen in the GLP1-RA arm (Rate Ratio, 6.60, 95% CI 2.67 to 16.29, P < 0.01). This is possibly the first meta-analysis conducted exclusively in patients with T2D and NAFLD which presents a strong signal that GLP1-RA, improve liver function and histology by improving glycaemia, reducing body weight and hepatic fat, which in turn reduces hepatic inflammation.Trial Registration: PROSPERO (ID: CRD42021228824).

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Prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) in Patients With Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa575 ◽

2020 ◽

Vol 105 (12) ◽

pp. 3842-3853

Author(s):

Marieke de Vries ◽

Jan Westerink ◽

Karin H A H Kaasjager ◽

Harold W de Valk

Keyword(s):

Type 1 Diabetes ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Data Extraction ◽

Meta Analysis ◽

Nonalcoholic Fatty Liver ◽

Pooled Prevalence

Abstract Context Nonalcoholic fatty liver disease (NAFLD) prevalence is high, especially in patients with obesity and type 2 diabetes, and is expected to rise steeply in the coming decades. Objective We estimated NAFLD prevalence in patients with type 1 diabetes and explored associated characteristics and outcomes. Data Sources We reviewed PubMed and Embase for studies on NAFLD and type 1 diabetes to March 2020. We screened references of included articles. Study Selection Two authors independently screened titles/abstracts. One author screened full text articles. NAFLD was defined as described in the individual studies: steatosis and/or fibrosis. Studies not reporting alternative causes of hepatic steatosis or defining NAFLD only as elevated liver enzymes, were excluded. Initially, 919 articles met the selection criteria. Data Extraction One researcher performed data extraction and risk of bias assessment using standardized tables. Data Synthesis We assessed pooled prevalence rates by meta-analysis using a random-effects model, subsequently exploring heterogeneity by subgroup-, meta-regression-, and sensitivity analysis. Twenty studies between 2009 and 2019 were included (n = 3901). Pooled NAFLD prevalence was 19.3% (95% CI, 12.3%-27.5%), increasing to 22.0% (95% CI, 13.9%-31.2%) in adults only. Pooled prevalence of ultrasound studies was high (27.1%, 95% CI, 18.7%-36.3%) compared to studies using magnetic resonance imaging (8.6%, 95% CI, 2.1%-18.6%), liver biopsy (19.3%, 95% CI, 10.0%-30.7%), or transient elastography (2.3%, 95% CI, 0.6%-4.8%). Conclusion NAFLD prevalence in patients with type 1 diabetes is considerable and is highly dependent on the specific diagnostic modality and NAFLD definition used. These data are helpful in directing actions to standardize NAFLD diagnosis, which will help defining contributing mechanisms and outcomes.

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