High prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus and normal plasma aminotransferase levels
Open accessAbstract
Context and objective Nonalcoholic fatty liver disease (NAFLD) and its more severe form with steatohepatitis (NASH) are common in patients with type 2 diabetes mellitus (T2DM). However, they are usually believed to largely affect those with elevated aminotransferases. The aim of this study was to determine the prevalence of NAFLD by the gold standard, liver magnetic resonance spectroscopy ((1)H-MRS) in patients with T2DM and normal aminotransferases, and to characterize their metabolic profile. Participants and methods We recruited 103 patients with T2DM and normal plasma aminotransferases (age, 60 ± 8 y; body mass index [BMI], 33 ± 5 kg/m(2); glycated hemoglobin [A1c], 7.6 ± 1.3%). We measured the following: 1) liver triglyceride content by (1)H-MRS; 2) systemic insulin sensitivity (homeostasis model assessment-insulin resistance); and 3) adipose tissue insulin resistance, both fasting (as the adipose tissue insulin resistance index: fasting plasma free fatty acids [FFA] × insulin) and during an oral glucose tolerance test (as the suppression of FFA). Results The prevalence of NAFLD and NASH were much higher than expected (50% and 56% of NAFLD patients, respectively). The prevalence of NAFLD was higher in obese compared with nonobese patients as well as with increasing BMI (P = .001 for trend). Higher plasma A1c was associated with a greater prevalence of NAFLD and worse liver triglyceride accumulation (P = .01). Compared with nonobese patients without NAFLD, patients with N…
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Individuals with MASLD and normal aminotransferase levels can still have significant steatohepatitis and develop advanced fibrosis or cirrhosis.
“However, individuals with MASLD and normal aminotransferase levels can still have signi fi cant steatohepatitis and develop advanced fi brosis or cirrhosis 22”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [22]
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- Authors
- Portillo-Sanchez, P., Bril, F., Maximos, M., Lomonaco, R., Biernacki, D., Orsak, B., Subbarayan, S., Webb, A., Hecht, J., & Cusi, K.
- Affiliations
- Division of Endocrinology, Diabetes and Metabolism (P.P.S., F.B., M.M., R.L., S.S., K.C.), University of Florida, Gainesville, Florida 32610
- University of Florida Health (US)
- Malcom Randall VA Medical Center (US)
- The University of Texas at San Antonio Health Science Center (US)
- Audie L. Murphy Memorial VA Hospital (US)
- Corresponding author
- Cusi, Kenneth
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2015-06-01
- Volume
- 100
- Issue
- 6
- Pages
- 2231-2238
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W4293860580
- Cited by
- 503
- References
- 36
- Citations by year
- 2026: 10 · 2025: 27 · 2024: 46 · 2023: 50 · 2022: 62 · 2021: 48 · 2020: 71 · 2019: 56 · 2018: 45 · 2017: 44 · 2016: 34 · 2015: 7
- FWCI
- 33.96
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs (I01 CX000167)
- National Institute on Aging (P30AG028740)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, type 2 diabetes, 1H magnetic resonance spectroscopy, insulin resistance, adipose tissue insulin resistance, obesity, HbA1c, prevalence, screening
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