Diabetes and Fatty Liver

Nonalcoholic fatty liver disease (NAFLD) affects more than 25% of the adult population worldwide. According to analyses for 2016, Germany ranks third behind Greece (41%) and Italy (25.4%) in the prevalence of NAFLD (22.9% of the total population). An increase in the prevalence of NAFLD to 26.4% has been calculated for Germany (2.3) for the year 2030. At around 70%, the frequency of NAFLD is particularly high in people with obesity and/or type 2 diabetes [2]. However, NAFLD also occurs in about 7% of lean people and is then primarily of genetic origin [2]. In Europe and the USA, NAFLD is now regarded as the most frequent cause of chronic liver diseases although most people with NAFLD die from secondary diseases resulting from diabetes or cardiovascular diseases. Therefore, it is particularly important to test patients with type 2 diabetes for the presence, and especially the degree of severity, of NAFLD, and to plan therapy accordingly [3] [4].

• References

• 1 Younossi ZM, Koenig AB, Abdelatif D. et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 2016; 64: 73-84
• 2 Younossi ZM. Non-alcoholic fatty liver disease - A global public health perspective. J Hepatol 2019; 70: 531-544
• 3 Estes C, Anstee QM, Arias-Loste MT. et al. Modeling NAFLD Disease Burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol 2018; 69: 896-904
• 4 Stefan N, Häring HU, Cusi K. Non-alcoholic fatty liver disease: causes, diagnosis, cardiometabolic consequences, and treatment strategies. Lancet Diabetes Endocrinol 2019; 7: 313-324
• 5 Tilg H, Moschen AR, Roden M. NAFLD and diabetes mellitus. Nat Rev Gastroenterol Hepatol 2017; 14: 32-42
• 6 European Association for the Study of the Liver (EASL); European European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical practice guidelines for the management of non-alcoholic fatty liver disease. Diabetologia 2016; 59: 1121-1140
• 7 Chalasani N, Younossi Z, Lavine JE. et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology 2018; 67: 328-357
• 8 Bril F, McPhaul MJ, Caulfield MP. et al. Performance of the SteatoTest, ActiTest, NashTest and FibroTest in a multiethnic cohort of patients with type 2 diabetes mellitus. J Investig Med 2019; 67: 303-311
• 9 Singh S, Allen AM, Wang Z. et al. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol 2015; 13: 643-654.e1-9
• 10 Adams LA, Anstee QM, Tilg H. et al. Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases. Gut 2017; 66: 1138-1153