Larger waistline links to increased liver damage risk in people with type 2 diabetes
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Waist circumference independently correlated with the risk for advanced fibrosis among patients with type 2 diabetes, according to a presenter at the European Association for the Study of Diabetes Annual Meeting.
“Advanced fibrosis is the main prognostic driver associated with overall mortality in nonalcoholic fatty liver disease. In type 2 diabetes, prevalence of advanced fibrosis, using vibration-controlled transient elastography (VCTE), has been reported to be as high as 15% to 20%,” Tiphaine Vidal-Trécan, MS, of the Lariboisière Hospital in Paris, France, and colleagues wrote. “However, relationship between advanced fibrosis and diabetic complications remains poorly known.”
To investigate the relationship between advanced fibrosis and type 2 diabetes, researchers analyzed 684 patients with type 2 diabetes (59% men; mean age, 61 years; average waist circumference, 104 cm) from Angiosafe, an ongoing, prospective cohort assessing the occurrence of diabetic complications in type 2 diabetes. Patients underwent fibrosis screening using VCTE from October 2019 to December 2020 with liver fibrosis staged according to liver stiffness measurement (LSM) for significant fibrosis (LSM 8 kPa; 22.5%), advanced fibrosis (LSM 10 kPa; 12.4%) and cirrhosis (LSM 15 kPa; 3.8%).
Researchers observed NAFLD in 74.4% of patients; macrovascular complications and incidence of retinopathy, neuropathy and nephropathy occurred in 24.8%, 20.55%, 39.4% and 38.3%, respectively. While the prevalence of nephropathy was increased among patients with advanced fibrosis (52.1% vs. 36.3%), there was no significant difference for macrovascular complications (23.6% vs. 25%), retinopathy (13.9% vs. 21.5%) or neuropathy (43% vs. 38.9%). Multivariate analysis revealed waist circumference (OR = 1.05), as well as aspartate aminotransferase (OR = 1.02), independently associated with advanced fibrosis in that each 1 cm increase in waist circumference correlated with a 5% higher likelihood of development.
“Doctors treating people with type 2 diabetes should be aware of these links and check for advanced fibrosis when their waist circumference or level of AST is high. A large waist circumference is linked to metabolic syndrome and fat accumulation in abdomen, which can lead to NAFLD,” Vidal-Trécan said in a Diabetologia press release. “Weight loss can reduce NAFLD, as can some medication, and the search for new drugs is gathering pace.”
Reference:
- Bigger waistlines raise the risk of serious liver damage in people with type 2 diabetes, study suggests. https://www.eurekalert.org/news-releases/929822. Published Sept. 29, 2021. Accessed Sept. 29, 2021.
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Vidal-Trécan T, et al. Abstract 672. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 27-Oct. 1, 2021 (virtual meeting).
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