|Petrozavodsk State University, 185910 Russia, Petrozavodsk, Lenin str., 33, email@example.com|
|Petrozavodsk State University, 185910 Russia, Petrozavodsk, Lenin str., 33, NALarina@inbox.ru|
|Institute of Biology, Karelian Research Centre RAS, 185910 Russia, Petrozavodsk, Pushkinskaya str., 11, firstname.lastname@example.org|
|Petrozavodsk State University, 85910 Russia, Petrozavodsk, Lenin str., 33, email@example.com|
nonalcoholic fatty liver disease
type 2 diabetes
The aim was to determine clinical features of nonalcoholic fatty liver disease (NAFLD) associated with type 2 diabetes (T2D). Materials and methods. 250 NAFLD patients were examined: 141 (56.4%) with T2D (group I) and 109 (43.6%) without T2D (group II). In group I, liver steatosis (LS) was revealed in 59 (41.8%), steatohepatitis (SH) in 79 (56.0%) and liver cirrhosis (LC) in 3 (2.1%) patients. It group II, LS, SH, and LC were found in 47 (43.1%), 62 (57.9%), and 0 (0%) patients, respectively. Routine laboratory tests were performed, and tumor necrosis factor alpha (TNF-α) was determined by ELISA. Results. 235 (94.0%) patients developed diabetes after NAFLD. Women accounted for 59.6% of NAFLD patients with T2D, the average age of this group was 10 years higher than that of NAFLD patients without T2D, and 3 (2.1%) patients of group I had cirrhosis. In NAFLD patients without T2D, nobody has LC. Mean age in LS+T2D subgroup was 61.80±11.80 years, in LS without T2D subgroup 53.81±10.06 (p<0.05), in SH+T2D subgroup 60.00±10.90 years, in SH without T2D subgroup 47.75±10.18 years (p<0.05). Alkaline phosphatase activity was higher in subgroups with T2D: 248.5±40.4 IU/l for LS+T2D, 210.85±48.51 IU/l for LS without T2D (p<0.05), 232.94±48.68 IU/l for SH+T2D, 201.88±36.44 IU/l for SH without T2D (p<0.05). Triglycerides were also higher in patients with T2D: 3.34±1.30 mmol/l for LS+T2D, 2.10±0.95 mmol/l for LS without T2D (p<0.05), 3.08±2.13 mmol/l for SH+T2D, 2.60±1.43 mmol/l for SH without T2D (p>0.05). TNF- level was higher in patients with T2D: 5.61±0.40 pg/ml for LS+T2D, 5.14±0.36 pg/ml for LS without T2D (p<0.05), 6.34±0.38 pg/ml SH+T2D, 5.90±0.43 pg/ml SH without T2D (p<0.05). Platelet rates were lower in subgroups with T2D: 227.00±58.05х109/l for LS+T2D, 246.15±54.85х109/l for LS without T2D (p<0.05), 228.36±40.26х109/l for SH+T2D, 249.05±51.90х109/l for SH without T2D (p<0.05). Conclusions. 1) Patients with T2D (56.4%) predominated among examined patients. In 94% of cases, T2D developed later than NAFLD. 2) Female gender and age were predictors of T2D development in patients with NAFLD. 3) NAFLD associated with T2D was characterized by more pronounced changes of clinical and laboratory parameters of hepatocellular inflammation and cholestasis, thus confirming its progressive course.