Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2019) 61 CD2.1 | DOI: 10.1530/endoabs.61.CD2.1

OU2019 Oral Communications Case Discussions: complex clinical cases 2.0 (3 abstracts)

Factors related to Non-Alcoholic Fatty Liver Disease (NAFLD) measures in obese subjects with early Type 2 Diabetes mellitus

Hadeel Zaghloul 1, , Odette Chagoury 1 , Barbara McGowan 2, , Shahrad Taheri 1 & Shahrad DIADEM-1 Study Team 1


1Weill Cornell Medicine, Doha, Qatar; 2King’s College London, London, UK; 3Guys and St Thomas NHS Trust, London, UK.


Introduction: T2DM (type 2 diabetes mellitus) appears to worsen the course of NAFLD (Non-Alcoholic Fatty Liver Disease) and NAFLD can make diabetes management more challenging. Long-term, NAFLD can lead to liver fibrosis, steatohepatitis, cirrhosis, and end-stage liver disease. This study aimed to examine factors associated with NAFLD measures in early T2DM.

Methods: Subjects (n=144) with early T2DM (<=3 years) and obesity (BMI>=27 kg/m2) aged 18–50 y were recruited into the Diabetes Intervention Accentuating Diet and Enhancing Metabolism – 1 (DIADEM-1) randomised controlled clinical trial. All participants received baseline assessments including anthropometric measurements, collection of fasted blood samples, and measurement of liver steatosis and fibrosis using the FibroScan.

Results: The mean liver controlled attenuation parameter (CAP) for subjects was 329 dB/m and the mean liver stiffness score was 7.2 kPa. Linear regression was used to determine the relation between steatosis and liver stiffness with cardio-metabolic factors, adjusting for age and gender. Both steatosis and liver stiffness were associated with body weight, body mass index (BMI), waist and neck circumference, fat mass, fat percentage, systolic blood pressure, insulin levels, HOMA-IR, and AST levels. Also, steatosis was correlated with HbA1c, fasting glucose, diastolic and mean arterial blood pressures, ALT and albumin-creatinine ratio. Only liver stiffness was correlated with the AST to platelet ratio (APRI).

Conclusion: NAFLD features are associated with measures of adiposity, insulin resistance, and cardiovascular health in obese individuals with early T2DM. NAFLD should be evaluated routinely in those with obesity and early T2DM as addressing NAFLD may result in improved cardio-metabolic outcomes.

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