BackgroundType 2 diabetes (T2D) seems to be a risk factor for the development of Non Alcoholic Fatty Liver Disease (NAFLD) and for its progression to fibrosis. The pathogenesis of the NAFLD-T2D association is not known. Recent data have shown that hyperinsulinemia and insulinresistance (IR) may be the primary phenomenon in NAFLD as well as inflammation.Aim of the study was to evaluate the prevalence of NAFLD in T2D, to correlate NAFLD with the Metabolic Syndrome (MetS) features and with T2D therapy, to evaluate the relation between NAFLD and genetic polymorphisms associated to IR, PC-1 K121Q, and inflammation, IL-6–174 C/G.Methods80 diabetic subjects were enrolled and underwent blood sample and medical history to ruled out alcohol consumption and other liver diseases aetiology. Steatosis was defined according to standardized ultrasonographic criteria and a score for each criterion was assigned like indicator of the severity of fatty liver infiltration (Fatty liver indicator, FLI).ResultsThe subjects studied were overweight with BMI=28.60 (25°÷ 75°=25.35÷ 32.95), had normal lipid profile and uric acid and had higher GPT levels (25°÷ 75°; GOT: 7.00÷ 27.25 and GPT: 21.00÷38.00)22.5% subjects had no steatosis whereas 77.5% had different severity of fatty liver infiltrationFLI did correlate significantly with BMI (p< 0.01), total Cholesterol (p<0.01), glycosilated haemoglobin (p<0.05) and TG (p<0.01)No correlation was found between T2D therapy and severity of NAFLD.No significant difference in polymorphisms prevalence was observed when NAFLD subjects were compared to a control group.DiscussionOur data show that T2D patients have a very high prevalence of NAFLD which is probably related to hyperinsulinism and IR. This is further supported by the positive correlation of NAFLD with BMI and TG. The lipogenic effects of insulin may underlie such relationship. In our population NAFLD associates with some features of MetS whereas no significant genetic component is present.
NAFLD AND TYPE 2 DIABETES: A GENETIC OR METABOLIC ISSUE? / Rondinella, S; Carulli, Lucia; Rudilosso, A; Ganazzi, D; Bertolotti, Marco; Loria, Paola; Carulli, Nicola. - In: EUROPEAN JOURNAL OF INTERNAL MEDICINE. - ISSN 0953-6205. - STAMPA. - 19:(2008), pp. 545-545. (Intervento presentato al convegno 7th congress of teh European Federation of Internal Medicine. tenutosi a Rome, Italy nel 07.05.2008).
NAFLD AND TYPE 2 DIABETES: A GENETIC OR METABOLIC ISSUE?
CARULLI, Lucia;BERTOLOTTI, Marco;LORIA, Paola;CARULLI, Nicola
2008
Abstract
BackgroundType 2 diabetes (T2D) seems to be a risk factor for the development of Non Alcoholic Fatty Liver Disease (NAFLD) and for its progression to fibrosis. The pathogenesis of the NAFLD-T2D association is not known. Recent data have shown that hyperinsulinemia and insulinresistance (IR) may be the primary phenomenon in NAFLD as well as inflammation.Aim of the study was to evaluate the prevalence of NAFLD in T2D, to correlate NAFLD with the Metabolic Syndrome (MetS) features and with T2D therapy, to evaluate the relation between NAFLD and genetic polymorphisms associated to IR, PC-1 K121Q, and inflammation, IL-6–174 C/G.Methods80 diabetic subjects were enrolled and underwent blood sample and medical history to ruled out alcohol consumption and other liver diseases aetiology. Steatosis was defined according to standardized ultrasonographic criteria and a score for each criterion was assigned like indicator of the severity of fatty liver infiltration (Fatty liver indicator, FLI).ResultsThe subjects studied were overweight with BMI=28.60 (25°÷ 75°=25.35÷ 32.95), had normal lipid profile and uric acid and had higher GPT levels (25°÷ 75°; GOT: 7.00÷ 27.25 and GPT: 21.00÷38.00)22.5% subjects had no steatosis whereas 77.5% had different severity of fatty liver infiltrationFLI did correlate significantly with BMI (p< 0.01), total Cholesterol (p<0.01), glycosilated haemoglobin (p<0.05) and TG (p<0.01)No correlation was found between T2D therapy and severity of NAFLD.No significant difference in polymorphisms prevalence was observed when NAFLD subjects were compared to a control group.DiscussionOur data show that T2D patients have a very high prevalence of NAFLD which is probably related to hyperinsulinism and IR. This is further supported by the positive correlation of NAFLD with BMI and TG. The lipogenic effects of insulin may underlie such relationship. In our population NAFLD associates with some features of MetS whereas no significant genetic component is present.
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