Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(3):442-448 | DOI: 10.5507/bp.2014.033

The prevalence of nonalcoholic liver steatosis in patients with type 2 diabetes mellitus in the Czech Republic

Karel Dvorak^a, Radvan Hainer^a, Jaromir Petrtyl^a, Miroslav Zeman^a, Tomas Vareka^a, Ales Zak^a, Renata Sroubkova^a, Tomislav Svestka^a, Libor Vitek^b, Radan Bruha^a

^a 4^th Department of Internal Medicine, 1^st Medical Faculty, Charles University in Prague, Czech Republic

^b Institute of Medical Biochemistry and Laboratory Diagnostics, 1^st Medical Faculty, Charles University in Prague

Aims: Nonalcoholic fatty liver disease (NAFLD) is associated with components of the metabolic syndrome (MS) but the prevalence of NAFLD in the Czech Republic is unknown. The aim of this study was to assess the latter in patients with type 2 diabetes (DM2) and to compare the noninvasive fibrosis scores with ultrasound findings in those patients.

Methods: 180 consecutive patients with DM2 (mean age 64.2±9.3 years, 63% men) were examined for liver biochemistry, MS parameters and had liver ultrasound. MS was diagnosed according to the International Diabetes Federation. The diagnosis of NAFLD was based on liver ultrasound. Other aetiology of liver lesion was ruled out. Additionally, AST/ALT ratio, APRI, NAFLD fibrosis score, FIB4 and BARD scores were calculated.

Results: 93% of patients met the MS criteria, 79% had NAFLD and 13% had ultrasound signs of fibrosis/cirrhosis. NAFLD patients had greater weight (96.9±19.3 vs 84.7±14.7 kg; P=0.003), BMI (32.6±5.2 vs 29.4±5.4 kg/m²; P=0.007), waist circumference (113.8±12.8 vs 107.1±10.3 cm; P=0.033), ALT (0.73±0.57 vs 0.55±0.53 µkat/L, P=0.007) and triglyceridaemia (1.9±1.4 vs 1.4±1 mmol/L; P=0.005) than patients without NAFLD. There were no significant differences in age, sex, cholesterol, fasting glycaemia or glycated haemoglobin. Of calculated scores only the NAFLD fibrosis score revealed significant differences between patients with and without ultrasound signs of fibrosis/cirrhosis (1.027±2.228 vs -0.118±1.402, P=0.026).

Conclusion: Patients with DM2 had in the majority of cases NAFLD which was related to weight, BMI, waist circumference and serum triglycerides. The validity of the liver fibrosis scoring system has to be assessed in those patients in the future.

Keywords: non-alcoholic fatty liver disease, steatosis, fibrosis, cirrhosis, metabolic syndrome, type 2 diabetes mellitus

Received: December 1, 2013; Accepted: June 6, 2014; Prepublished online: June 25, 2014; Published: September 30, 2015  Show citation