Predictors of NAFLD rapidly progression in type 2 diabetes patients
DOI:
https://doi.org/10.12775/JEHS.2020.10.10.021Keywords
diabetes mellitus type two, nonalcoholic fatty liver disease, fibrosisAbstract
The goal of our case-control research was to study the associations between speed progression of NAFLD and risk factors among patients with the type 2 diabetes. 82 patients with type 2 diabetes and NAFLD took part in the study. We divided the patients into two groups: with speed (n=38) and slow (n=44) progression of fibrosis. The results of our study revealed the definitive associations between speedy progression of fibrosis and the level of insulin, ACT and alkaline phosphatase. We found the direct relations of speed fibrosis progression with the level of TC and TG. We also showed the significant influence the inflammatory mechanisms have on fibrosis progression (direct definitive relations between fibrosis and the consistence of cytokines - IL-1β (OR 1,017; р=0,035), TNF-α (OR 0,004; р=0,049) and the inverse relations between the speed progression of fibrosis and the consistence of IL-6 (OR 0,94; р=0,058).
Using the results of a step-by-step multivariate regression analysis we created the final clinical model of fibrosis speed progression among the type two diabetes patients and people affected with NAFLD, which includes six prognostic variables: TG, alkaline phosphatase, insulin, IL-6, TNF-α and adiponectin.
References
Noureddin M, Vipani A, Bresee C, Todo T, Kim IK, Alkhouri N, Setiawan VW, Tran T, Ayoub WS, Lu SC, Klein AS, Sundaram V, Nissen NN. NASH Leading Cause of Liver Transplant in Women: Updated Analysis of Indications For Liver Transplant and Ethnic and Gender Variances. Am J Gastroenterol. 2018;113:1649-59.
Suzuki A, Diehl AM. Nonalcoholic Steatohepatitis. Annu Rev Med. 2017;68:85-98.
Setiawan VW, Stram DO, Porcel J, Lu SC, Le Marchand L, Noureddin M. Prevalence of chronic liver disease and cirrhosis by underlying cause in understudied ethnic groups: The multiethnic cohort. Hepatology. 2016;64:1969-77.
Younossi ZM. Non-alcoholic fatty liver disease - A global public health perspective. J Hepatol. 2019;70:531-44.
Dulai PS, Singh S, Patel J, Soni M, Prokop LJ, Younossi Z, Sebastiani G, Ekstedt M, Hagstrom H, [et al]. Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: Systematic review and meta-analysis. Hepatology. 2017;65(5):1557-65. doi: 10.1002/hep.29085. Epub 2017 Mar 31.
Friedman SL, Neuschwander-Tetri BA, Rinella M, Sanyal AJ. Mechanisms of NAFLD development and therapeutic strategies. Nat Med. 2018;24:908-22.
European Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64:1388–402.
Bugianesi E. Non-alcoholic steatohepatitis and cancer. Clinics in Liver Disease. 2007;11(1):191–207.
Tarantino G, Conca P, Pasanisi F, Ariello M, Mastrolia M, Arena A, Tarantino M, [et al.]. Could inflammatory markers help diagnose nonalcoholic steatohepatitis? Eur J Gastroenterol Hepatol. 2009; 21(5):504-11. doi: 10.1097/MEG.0b013e3283229b40
Vilar-Gomez E, Yasells-Garcia A, Martinez-Perez Y, Calzadilla-Bertot L, Torres-Gonzalez A, Gra-Oramas B, et al. Development and validation of a noninvasive prediction model for nonalcoholic steatohepatitis resolution after lifestyle intervention. Hepatology 2016;63:1875–87.
Popov Y, Schuppan D. Targeting liver fibrosis: Strategies for development and validation of antifibrotic therapies. Hepatology 2009;50:1294–306.
Friedman SL, Sheppard D, Duffield JS, Violette S. Therapy for fibrotic diseases: nearing the starting line. Sci Transl Med 2013;5:1–17.
Rockey DC, Bell PD, Hill JA. Fibrosis–a common pathway to organ injury and failure. N Engl J Med 2015;372:1138–49.
Friedman SL, Trautwein C, Schuppan D, Pinzani M. Hepatic fibrosis: Concept to treatment. J Hepatol 2015;62:S15–24.
Fallowfield JA. Future mechanistic strategies for tackling fibrosis–an unmet need in liver disease. Clin Med (Lond) 2015;15:83–87.
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