Fatty liver disease increases heart disease risk and mortality in type 2 diabetes

A new UK study shows that non-alcoholic fatty-liver disease (NAFLD) is associated with higher all-cause mortality and incidence of cardiovascular disease (CVD) events in people with type 2 diabetes.
Researchers have found that mortality rates for people with type 2 diabetes and a history of NAFLD were double those for people with type 2 diabetes but no record of NAFLD.
The research, led by scientists at the University of Edinburgh, highlights NAFLD-associated mortality risks from a range of causes, including cardiovascular disease and a form of liver cancer known as hepatocellular carcinoma.
The trial involved more than 130,000 participants with type 2 diabetes followed over four years and who had been admitted at least once to hospital due to complications of NAFLD.
Participants who had developed liver disease from alcohol, medication or viral causes were excluded from the study.
The association found between NAFLD and incident CVD was independent of other factors which increase the risks of developing cardiovascular events, such as smoking, high blood pressure and certain medications.
NAFLD is a term that encompasses varying degrees of liver disease which, according to the researchers, is thought to be present in over half of people with type 2 diabetes.
In the study, the majority of participants had less severe fatty liver disease, nonalcoholic steatohepatitis (NASH), or only one or more signs of serious liver tissue damage.
The results show that the more severe the form of NAFLD, the higher the mortality risk across all causes, which stresses how crucial the early identification of NAFLD in type 2 diabetes is to lower risks.
Previous research indicates that among people with type 2 diabetes and NAFLD, those found to be most at risk for CVD, in particular, tend to be older, have higher HbA1c levels, a high body mass index (BMI) and elevated LDL cholesterol levels.
This suggests that addressing some of those lifestyle-related risk factors can help lower increased odds of CVD in people with type 2 diabetes and existing NAFLD.