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Fibrosis predicts T2DM, AHT in metabolically healthy NAFLD patients

30 Jun 2020

Healthy patients with significant fibrosis related to nonalcoholic fatty liver disease (NAFLD) are at a higher risk of developing type 2 diabetes mellitus (T2DM) and arterial hypertension (AHT), a recent study has shown.

The study included 178 patients (mean age, 44.5±12 years; 56 percent male) with biopsy-proven NAFLD, but who were metabolically healthy, as defined by a baseline absence of T2DM, AHT, and dyslipidaemia. Fibrosis measures included the Hepamet Fibrosis Score (HFS), NAFLD Fibrosis Score, and FIB-4. Outcomes were changes in metabolic health.

Patients were followed for an average of 5.6±4.4 years, during which time nine percent (n=16) developed T2DM and 8.4 percent (n=15) developed AHT. Low high-density lipoprotein levels were reported in 9.6 percent (n=17), while hypertriglyceridemia was observed in 23.6 percent (n=42). Only one death was reported.

T2DM occurred significantly more commonly among patients with significant vs mild fibrosis (17.1 percent vs 7 percent; p=0.006). This was further confirmed by multivariate analysis, which found that significant fibrosis increased the risk of T2DM (hazard ratio [HR], 2.95, 95 percent confidence interval [CI], 1.19–7.31; p=0.019).

Similar patterns were observed with AHT, which occurred more frequently in those with significant fibrosis (17.1 percent vs 6.3 percent; p=0.005). In turn, significant fibrosis emerged as an important risk factor for AHT (HR, 2.39, 95 percent CI, 1.14–5.10; p=0.028).

Other important risk factors for both metabolic outcomes included age, body mass index, and glucose concentration.

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Most Read Articles
5 days ago
Routinely used for treating cardiovascular diseases, statins have been shown to benefit other conditions, and new evidence suggests that using the drug at high intensity reduces the risk of hip or knee replacement, an effect that may be specific to rheumatoid arthritis.
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