Non-alcoholic fatty liver disease increases cardiovascular and mortality risk in patients with diabetes

1. The risk of cardiovascular disease (CVD) and all-cause death for individuals with type 2 diabetes mellitus (T2DM) is increased for those with non-alcoholic fatty liver disease (NAFLD) compared to those without NAFLD. 

Evidence Rating Level: 2 (Good)

Non-alcoholic fatty liver disease (NAFLD) is increasing in prevalence globally. Patients with NAFLD are at an increased risk for developing cirrhosis, as well as cardiovascular disease (CVD). CVD is the leading cause of death for individuals with NAFLD. In this longitudinal cohort study, researchers aimed to assess the risk of NAFLD on CVD and all-cause mortality among participants with and without type 2 diabetes mellitus (T2DM). Data were collected on 7,796,763 participants via the National Health Screening Program in Korea starting in 2009. The median follow-up period was 8.13 years. Participants were categorized as having no NAFLD, grade 1 NAFLD, or grade 2 NAFLD. 6.49% of participants had T2DM. The incidence rate of CVD and all-cause mortality increased with the grade of NAFLD, and the incidence rates among those with T2DM were greater compared to those without T2DM. In addition, the 5-year absolute risk of CVD and all-cause mortality increased with the grade of NAFLD for patients with and without T2DM but was greater for those with T2DM. A limitation of this study is that NAFLD was defined by the fatty liver index, as opposed to biopsy or ultrasound. Additionally, the study was only conducted among a Korean population; as such, further research is needed to confirm these results among other populations. Overall, this study demonstrates an association between NAFLD and the risk of CVD and all-cause mortality for patients with T2DM. 

Click to read the study in BMJ

Image: PD

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