Metabolic (Dysfunction)-Associated Fatty Liver Disease in Chinese Patients with Type 2 Diabetes from a Subcenter of the National Metabolic Management Center

• Published in: Journal of Diabetes Research Vol. 2022; pp. 8429847 - 9
• Main Authors: Guan, Conghui, Fu, Songbo, Zhen, Donghu, Yang, Kuan, An, Jinyang, Wang, Yapei, Ma, Chengxu, Jiang, Na, Zhao, Nan, Liu, Jinjin, Yang, Fang, Tang, Xulei
• Format: Journal Article
• Language: English
• Published: England Hindawi 28.01.2022; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Abdomen; Adolescent; Adult; Age; Aged; Body Mass Index; China - epidemiology; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetes therapy; Diabetics; Epidemiology; Fatty liver; Female; Food Quality; Glucose; High density lipoprotein; Hospitals; Humans; Immunoassay; Insulin resistance; Liver diseases; Logistic Models; Male; Metabolism; Middle Aged; Non-alcoholic Fatty Liver Disease - epidemiology; Non-alcoholic Fatty Liver Disease - etiology; Obesity; Overweight; Patient education; Type 2 diabetes; Ultrasonic imaging; Ultrasonography - methods; Ultrasonography - statistics & numerical data; Young Adult; China
• ISSN: 2314-6745; 2314-6753
• DOI: 10.1155/2022/8429847

Background. Few studies have investigated the epidemiological metabolic (dysfunction) associated with fatty liver disease (MAFLD) in China, especially among those with type 2 diabetes. Methods. We recruited 3553 patients aged 18-75 years with type 2 diabetes who underwent abdominal ultrasound and serum biochemical analyses. Patient information including demographic and anthropometric parameters was also collected. Results. Overall, 63.2% of type 2 diabetic patients had MAFLD. Among the MAFLD patients, the proportions of lean, nonobese, and obese MAFLD were 23.1%, 75.7%, and 24.3%, respectively, and the percentage of previously undiagnosed MAFLD was 42.2%. MAFLD patients were younger, had shorter diabetic duration, and had greater BMI, aspartate aminotransferase (AST), alanine aminotransferase (ALT), fasting insulin, postprandial insulin, total cholesterol, and insulin resistance levels (HOMA-IR and TyG index). Liver fibrosis diagnostic panels revealed that the proportions of elevated AST (≥40 U/L) and ALT (≥40 U/L) were 7.3% and 18.5%, respectively. The distributions of AST-to-platelet ratio index (APRI), fibrosis-4 (FIB-4) index, and nonalcoholic fatty liver disease fibrosis score (NFS) per stage were as follows: APRI—low 55.1%, indeterminate 35.3%, and high 9.5%; FIB-4—low 48.2%, indeterminate 45.3%, and high 6.5%; and NFS—low 15.0%, indeterminate 70.0%, and high 13.0%. Conclusions. MAFLD is a very common condition and generally had greater frequency of metabolic characteristics among type 2 diabetics in China. Many MAFLD patients were in the “indeterminate” or “high” stage when APRI, FIB-4, and NFS were assessed. Assessment of MAFLD should be included in the management of type 2 diabetes.