Depicting a patient with type 2 diabetes, focusing on the heart and liver to represent cardiovascular disease and non-alcoholic fatty liver disease.
Non-alcoholic fatty liver disease (NAFLD) is an underrecognized condition, especially in patients with type 2 diabetes. However, its impact on cardiovascular health and overall mortality is significant. A recent study highlights the importance of identifying and managing NAFLD to mitigate these health risks.
The researchers, using a large population-based cohort, discovered that NAFLD notably increases the risk of cardiovascular disease and all-cause death in individuals with type 2 diabetes. These findings provide a comprehensive view of the significant burden NAFLD places on this patient group.
“Our results showed that NAFLD in type 2 diabetes patients is associated with a higher likelihood of cardiovascular complications and even death,” explains Kyung-Soo Kim, one of the study’s authors. “These findings call for greater attention to NAFLD during diabetes care.”
By analyzing data from over 1 million patients, the study created a clear picture of how the presence of NAFLD exacerbates health outcomes. The research utilized Kaplan-Meier survival curves to assess the long-term impact of NAFLD on cardiovascular events and mortality rates, revealing a stark contrast between those with and without the liver condition.
“The strength of our study lies in its extensive population-based design, which allowed us to capture a broad range of data on the interaction between diabetes and NAFLD,” Kyungdo Han added. “Clinicians should carefully consider NAFLD when managing diabetic patients.”
One of the more surprising aspects of the study was the high rate of undiagnosed or untreated NAFLD in diabetic patients. Many people may be unaware of the presence of fatty liver disease, as it often shows no symptoms. Yet, the condition silently increases the risk of serious cardiovascular events and death.
“These results are a wake-up call,” Sangmo Hong commented. “We need more rigorous screening for NAFLD in diabetic patients, especially given how treatable the condition is through lifestyle changes and medical intervention.”
The study also explored various subgroups, including patients with different levels of obesity, alcohol consumption, and exercise habits. Each of these factors seemed to influence the degree of risk posed by NAFLD, but the overall message was clear: fatty liver disease and type 2 diabetes are a dangerous combination.
“Effective management of both diabetes and NAFLD is crucial for improving patient outcomes,” says Cheol-Young Park. “This study should inform clinical guidelines and encourage healthcare providers to adopt a more comprehensive approach to patient care.”
By raising awareness of NAFLD as a critical comorbidity, this research could lead to more proactive screening and treatment strategies for diabetic patients, ultimately reducing the incidence of cardiovascular disease and all-cause mortality.
Citation: Kim KS, Hong S, Han K, Park C-Y. Association of non-alcoholic fatty liver disease with cardiovascular disease and all cause death in patients with type 2 diabetes mellitus: nationwide population based study. BMJ. 2024;384. doi:10.1136/bmj-2023-076388
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