Author information
1
Nepean Clinical School, The University of Sydney, Kingswood, New South Wales 2747, Australia; Nepean Hospital, Kingswood, New South Wales 2747, Australia; Dept of Endocrinology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia; Greg Brown Diabetes and Endocrinology Research Laboratory, Charles Perkins Centre and Bosch Institute, Building D17, The University of Sydney, New South Wales 2006, Australia.
2
Dept of Endocrinology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia; Westmead Hospital, Cnr Darcy Road and Bridge Street, Westmead, NSW 2145, Australia.
3
Dept of Endocrinology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia; Greg Brown Diabetes and Endocrinology Research Laboratory, Charles Perkins Centre and Bosch Institute, Building D17, The University of Sydney, New South Wales 2006, Australia. Electronic address: stephen.twigg@sydney.edu.au.
Abstract
AIMS:
The impact of non-alcoholic fatty liver disease (NAFLD) presence and severity on the diabetes phenotype remains unclear. Our study aimed to explore and contrast the phenotypes associated with higher ALT and high-risk NAFLD fibrosis score (NFS) in type 2 diabetes.
METHODS:
324 patients with type 2 diabetes mellitus who were seen at a diabetes centre for a complications assessment with data for NFS were available for study. Data regarding co-morbidities and pathology were obtained at assessment and by file audit. Logistic regression was used to determine if there were significant relationships between pre-determined diabetes complications and co-morbidities and ALT or high-risk NFS (>0.675).
RESULTS:
Significant univariate associations with lower ALT included those of osteoporosis/osteopenia and inability to sense the monofilament. High-risk NFS was associated with arrhythmia, VPT ≥ 25 V and albuminuria. The associations of high-risk NFS with albuminuria and VPT ≥ 25 V remained after adjustment.
CONCLUSIONS:
In type 2 diabetes, the clinical phenotype of those with higher ALT is dissimilar, sometimes inverse, to those with high-risk NFS. More emphasis should be placed on liver fibrosis risk rather than on liverenzymes alone.