Atherogenic dyslipidemia, but not hyperglycemia, is an independent factor associated with liver fibrosis in subjects with type 2 diabetes and NAFLD: a population-based study.
Por:
Julián MT, Pera G, Soldevila B, Caballería L, Julve J, Puig-Jové C, Morillas R, Torán P, Expósito C, Puig-Domingo M, Castelblanco E, Franch-Nadal J, Cusi K, Mauricio D and Alonso N
Publicada:
1 abr 2021
Resumen:
OBJECTIVE: To investigate the prevalence and risks factors associated with the presence of liver fibrosis in subjects with nonalcoholic fatty liver disease (NAFLD) with and without type 2 diabetes mellitus (T2D). DESIGN AND METHODS: This study was part of a population-based study conducted in the Barcelona metropolitan area among subjects aged 18-75 years old. Secondary causes of steatosis were excluded. Moderate-to-advanced liver fibrosis was defined as a liver stiffness measurement (LSM) = 8.0 kPa assessed by transient elastography. RESULTS: Among 930 subjects with NAFLD, the prevalence of moderate-to-advanced liver fibrosis was higher in subjects with T2D compared those without (30.8% vs 8.7%). By multivariable analysis, one of the main factors independently associated with increased LSM in subjects with NAFLD was atherogenic dyslipidemia but only in those with T2D. The percentage of subjects with LSM = 8.0 kPa was higher in subjects with T2D and atherogenic dyslipidemia than in those with T2D without atherogenic dyslipidemia both for the cut-off point of LSM =8.0 kPa (45% vs 24% P = 0.002) and =13 kPa (13% vs 4% P = 0.020). No differences were observed in the prevalence of LSM =8.0 kPa regarding glycemic control among NAFLD-diabetic subjects. CONCLUSIONS: Factors associated with moderate-to-advanced liver fibrosis in NAFLD are different in subjects with and without T2D. Atherogenic dyslipidemia was associated with the presence of moderate-to-advanced liver fibrosis in T2D with NAFLD but not in non-diabetic subjects. These findings highlight the need for an active search for liver fibrosis in subjects with T2D NAFLD and atherogenic dyslipidemia.
Filiaciones:
Julián MT:
Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
Pera G:
Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Spain
Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain
:
Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
Department of medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
Caballería L:
Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Spain
Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain
Julve J:
Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Barcelona, Spain
Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
Puig-Jové C:
Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
:
Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain
Hepatology Department, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
Torán P:
Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Spain
Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain
Expósito C:
Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Spain
Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain
:
Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
Department of medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
Castelblanco E:
Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
Franch-Nadal J:
Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
Primary Health Care Center Raval Sud, Gerència d'Atenció Primaria, Institut Català de la Salut, Barcelona, Spain
Cusi K:
Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, Florida, USA
Mauricio D:
Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
Faculty of Medicine, University of Vic, Central University of Catalonia, Vic, Spain
:
Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
Department of medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
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