Prevalence of Nonalcoholic Fatty Liver Disease and Its Association With Cardiovascular Disease Among Type 2 Diabetic Patients

Giovanni Targher; Lorenzo Bertolini; Roberto Padovani; Stefano Rodella; Roberto Tessari; Luciano Zenari; Christopher Day; Guido Arcaro

doi:10.2337/dc06-2247

journal article May 01, 2007

Prevalence of Nonalcoholic Fatty Liver Disease and Its Association With Cardiovascular Disease Among Type 2 Diabetic Patients

Giovanni Targher

Lorenzo Bertolini Roberto Padovani Stefano Rodella Roberto Tessari Luciano Zenari Christopher Day Guido Arcaro

Diabetes Care Vol. 30 No. 5 pp. 1212-1218 · American Diabetes Association

View at Publisher Save 10.2337/dc06-2247

Abstract

OBJECTIVE—To determine the prevalence of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetic population and to compare the prevalence of cardiovascular disease (CVD) and its risk factors between people with and without NAFLD.
RESEARCH DESIGN AND METHODS—The entire sample of type 2 diabetic outpatients (n = 2,839) who regularly attended our clinic was screened. Main outcome measures were NAFLD (by patient history and liver ultrasound) and manifest CVD (by patient history, review of patient records, electrocardiogram, and echo-Doppler scanning of carotid and lower limb arteries).
RESULTS—The unadjusted prevalence of NAFLD was 69.5% among participants, and NAFLD was the most common cause (81.5%) of hepatic steatosis on ultrasound examination. The prevalence of NAFLD increased with age (65.4% among participants aged 40–59 years and 74.6% among those aged ≥60 years; P &lt; 0.001) and the age-adjusted prevalence of NAFLD was 71.1% in men and 68% in women. NAFLD patients had remarkably (P &lt; 0.001) higher age and sex-adjusted prevalences of coronary (26.6 vs. 18.3%), cerebrovascular (20.0 vs. 13.3%), and peripheral (15.4 vs. 10.0%) vascular disease than their counterparts without NAFLD. In logistic regression analysis, NAFLD was associated with prevalent CVD independent of classical risk factors, glycemic control, medications, and metabolic syndrome features.
CONCLUSIONS—NAFLD is extremely common in people with type 2 diabetes and is associated with a higher prevalence of CVD. Follow-up studies are needed to determine whether NAFLD predicts the development and progression of CVD.

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References

Details

Published: May 01, 2007
Vol/Issue: 30(5)
Pages: 1212-1218

Authors

G

Giovanni Targher

Department of Internal Medicine, “Sacro Cuore” Hospital, Negrar, Italy; Section of Endocrinology, Department of Biomedical and Surgical Sciences, University Hospital of Verona, Verona, Italy

L

Lorenzo Bertolini