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People with type 2 diabetes had more liver fat than people without diabetes
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People with type 2 diabetes had 80% more liver fat than patients without type 2 diabetes, regardless of age, BMI and sex.
Researchers from Finland enrolled 70 participants with type 2 diabetes and 70 participants without diabetes who were matched for age, BMI and sex. Participants with type 2 diabetes also had 16% more intra-abdominal fat than participants without diabetes.
The amount of liver fat at high concentrations of serum alanine aminotransferase (50 U/L – 200 U/L) was 70% to 200% higher in participants with type 2 diabetes than in participants without diabetes.
In both groups, liver fat content corresponded to concentrations of fasting serum insulin (r=0.55; P<.0001), C-peptide (r=0.40; P<.0001), HbA1c (r=0.34; P<.0001), fasting plasma glucose (r=0.29; P=.0006), fasting serum triglyceride (r=0.36; P<.0001) and fasting serum HDL cholesterol (r=–0.31; P=.0002). – by Christen Haigh
Diabetes Care. 2008;31:165-169.
It is well known that hepatic steatosis is more common in people with type 2 diabetes and frequently seen in the setting of the metabolic syndrome. These findings provide additional information on the potential pathophysiologic nature of the metabolic syndrome and help tie the syndrome together.
The key points are that the hepatic transaminases underestimate the presence of liver fat content in both diabetes mellitus and non-diabetes mellitus (significantly more unreliable in the diabetes mellitus vs. non-diabetes mellitus), and individuals with type 2 diabetes mellitus have significantly more liver fat at any given BMI (that is regardless of obesity).
Also, this higher fat content in diabetes mellitus may help to explain, in-part, the pathophysiologic mechanism of diabetic dyslipidemia.
This data supports previous study findings of “minimal to no” impact of statins and other anti-diabetic medications on fatty liver. This study excluded subjects concurrently taking thiazolidinediones which is unfortunate, given this class of drugs have been shown to improve fatty liver.
Given the significant medical problems associated with hepatic steatosis, the prevalence of the disease, the impracticality of using MRI on everyone at risk and the unreliability of transaminases to diagnosis the disease, new serum markers are needed.
– Dara P. Schuster, MD
Endocrinology, diabetes and glucose metabolism, the Ohio State Medical Center in Columbus