Atherogenic dyslipidemia, but not hyperglycemia, is an independent factor associated with liver fibrosis in subjects with type 2 diabetes and NAFLD: A population-based study


Por: Julián M.T., Pera G., Soldevila B., Caballería L., Julve J., Puig-Jové C., Morillas R., Torán P., Expósito C., Puig-Domingo M., Castelblanco E., Franch-Nadal J., Cusi K., Mauricio D., Alonso N.

Publicada: 1 ene 2021
Resumen:
Objective: To investigate the prevalence and risks factors associated wit h the presence of liver fibrosis in subjects with nonalcoholic fatty liver disease (NAFLD) with and without type 2 diabetes mellitus (T2D). Design and methods: This study was part of a population-based study conducted in t he Barcelona metropolitan area among subjects aged 18-75 years old. Secondary causes of steato sis were excluded. Moderate-to-advanced liver fibrosis was defined as a liver stiffness measurement (LSM) = 8.0 kPa assessed by transient elastography. Results: Among 930 subjects with NAFLD, the prevalence of moderate-to-a dvanced liver fibrosis was higher in subjects with T2D compared those without (30.8% vs 8.7%). By multivariab le analysis, one of the main factors independently associated with increased LSM in subjects with NAFLD was athero genic dyslipidemia but only in those with T2D. The percentage of subjects with LSM = 8.0 kPa was higher in subjects with T2D and atherogenic dyslip idemia than in those with T2D without atherogenic dyslipidemia both for the cut-off p oint of LSM =8.0 kPa (45% vs 24% P = 0.002) and =13 kPa (13% vs 4% P = 0.020). No differences were observed in the prevalence of LSM =8.0 kPa regarding glycemic control among NAFLD-diabetic subjects. Conclusions: Factors associated with moderate-to-advanced liver fibrosis in NAFLD are different in subjects with and without T2D. Atherogenic dyslipidemia was associated with the p resence of moderate-to-advanced liver fibrosis in T2D with NAFLD but not in non-diabetic subjects. These findings high light the need for an active search for liver fibrosis in subjects with T2D NAFLD and atherogenic dyslipidemia. © 2021 European Society of Endocrinology.

Filiaciones:
Julián M.T.:
 Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain

Pera G.:
 Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Spain

 Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain

Soldevila B.:
 Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain

 Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

Caballería L.:
 Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Spain

 Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain

Julve J.:
 Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain

 Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Barcelona, Spain

 Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

Puig-Jové C.:
 Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain

Morillas R.:
 Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain

 Hepatology Department, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain

Torán P.:
 Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Spain

 Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain

Expósito C.:
 Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Spain

 Centro d'Investigaciones Biomédicas en Red, Enfermedades Hepatologia y Digestivas, Barcelona, Spain

Puig-Domingo M.:
 Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain

 Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

 Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

Castelblanco E.:
 Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain

 Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

Franch-Nadal J.:
 Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

 Primary Health Care Center Raval Sud, Gerència d'Atenció Primaria, Institut Català de la Salut, Barcelona, Spain

Cusi K.:
 Division of Endocrinology Diabetes and Metabolism, University of Florida, Gainesville, FL, United States

Mauricio D.:
 Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain

 Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

 Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain

 Faculty of Medicine, University of Vic, Central University of Catalonia, Vic, Spain

Alonso N.:
 Department of Endocrinology and Nutrition, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain

 Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

 Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
ISSN: 08044643
Editorial
BIOSCIENTIFICA LTD, STARLING HOUSE, 1600 BRISTOL PARKWAY N, BRISTOL, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 184 Número: 4
Páginas: 587-596
ID de PubMed: 33606661
imagen Open Access

MÉTRICAS