Recent study data suggest an association between waist circumference and progression of nonalcoholic fatty liver disease (NAFLD) in people with type 2 diabetes. In NAFLD, fat accumulates in the liver, which can lead to life-threatening hepatic sequelae.
The term nonalcoholic fatty liver disease (NAFLD) subsumes liver abnormalities ranging from steatosis hepatis to nonalcoholic fatty liver hepatitis or steatohepatitis (NASH). The prevalence of NAFLD is increasing in parallel with the rise in diabetes mellitus and metabolic syndrome worldwide. Obesity is considered a common risk factor for NAFLD and type 2 diabetes. It is known that up to 15-20% of patients with type 2 diabetes have advanced hepatic fibrosis, and those with severe obesity are particularly at risk. This is because a large waist circumference is associated with metabolic syndrome and the accumulation of fat in the abdominal area, which can lead to NAFLD. In a study by a research team led by Dr. Tiphaine Vidal-Trécan of Lariboisiere Hospital, Paris (F), 684 type 2 diabetic patients were studied who had a mean BMI of 28.7 kg/m2 and a mean waist circumference of 104 cm. The average age of the subjects was 61 years. Vibration-guided transient elastography scans showed that 74.5% of study participants were affected by NAFLD. Advanced fibrosis was present in 12.4%. Higher aspartate aminotransferase (AST) levels, a marker of liver damage, were associated with a higher likelihood of advanced fibrosis. Dr. Vidal-Trécan concludes, “Physicians treating people with type 2 diabetes should be aware of these associations and look for advanced fibrosis if their waist circumference or AST levels are high.” The study found that each 1 cm increase in waist size was associated with a 5% increase in the likelihood that participants would develop advanced fibrosis. The rates of the other complications (macrovascular, retinopathy, and neuropathy) did not differ between those with advanced fibrosis and the other T2D patients in this study.
Source: “Bigger waistlines raise the risk of serious liver damage in people with type 2 diabetes, study suggests,” EASD, 9/28/2021.
HAUSARZT PRAXIS 2022; 17(1): 19
