Non-Alcoholic Fatty Liver Disease Is not Related to the Prevalence of Diabetic Polyneuropathy in Diabetes

Aim: Nonalcoholic fatty liver disease (NAFLD) has been suggested as independent predictor for kidney disease and proliferative retinopathy in patients with type 2 diabetes (T2D), while the association with diabetic polyneuropathy (DPN) is debated. The aim of this study is to evaluate the association between DPN and predictive tools and ultrasonography diagnosis of NAFLD. Methods: Forty-two diabetic patients (mean age 57.83 ± 11.47 years, duration 9.44 ± 8.92 years, HbA1c 59.19 ± 13.85 mmol/mol, 27 males, 93% T2DM), underwent clinical evaluation of DPN by Michigan Neuropathy Screening Instrument (MNSI), Michigan Diabetic Neuropathy Score (MDNS) and Diabetic Neuropathy Index (DNI). NAFLD was evaluated by predictive tools Fatty Liver Index (FLI) and Hepatic Steatosis Index (HIS), and confirmed by liver ultrasonography. Results: DPN was present in 22 (52.4%) participants. DPN patients were older (p=0.04) and characterized by higher prevalence of impaired urinary albumin excretion (p=0.035), hypertension (p=0.011) and dyslipidemia (p=0.041). High risk FLI and HIS scores were detected in 81% and 64.3% of subjects, while ultrasonography NAFLD was present in 31 out of 36 (85.7%%) patients (20 with mild and 11 with moderate-severe grade), resulting more frequent in females than males (93.3% versus 63.0%, p=0.032). 87 No significant difference was found in DPN prevalence in patients with NAFLD than those without (54.8 versus 45.2 %, p=0.338), also considering only high grade steatosis. No association was identified between DPN and non-invasive predictive tools of NAFLD. Conclusion: Although in a small sample of diabetic subjects, liver steatosis is not independently associated with clinical diagnosis of DPN.