Nonalcoholic fatty liver disease--a risk factor for microalbuminuria in type 2 diabetic patients.

UNLABELLED: The aim of our study was to assess the presence of microalbuminuria in diabetic subjects with nonalcoholic fatty liver disease (NAFLD) compared with diabetic patients without NAFLD and to correlate this with inflammatory markers such as high sensitive C- reactive protein (hsCRP). MATERIAL AND METHODS: The study was conducted on 75 diabetic subjects with ultrasonographical NAFLD, in which alcohol consumption and other causes of chronic liver disease have been excluded. The exclusion criteria also included smoking, arterial hypertension, known renal disease. The control group consisted of 70 diabetic patients, matched for age and gender, without ultrasonographical evidence of NAFLD. In all subjects we measured height, weight, BMI, fasting glucose, HbA1c, total cholesterol, LDL and HDL cholesterol, triglycerides, serum transaminases, hsC-reactive protein and microalbuminuria. A p-value <0.05 was considered statistically significant. RESULTS: Microalbuminuria was significantly more frequent in subjects with NAFLD than in controls (12.7% vs 7.8%, p<0.05). Microalbuminuria was positively correlated with hsCRP levels. In conclusion NAFLD is positively correlated with microalbuminuria-marker of early stage CKD, in diabetic patients. This seems to be related to higher levels of proinflammatory factors released by the liver, such as hsCRP.

Glycoregulation disorders and alterations of C reactive protein in nonalcoholic fatty liver disease.

UNLABELLED: Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological condition which ranges from simple steatosis and steatohepatitis to cryptogenetic cirrhosis. As insulinresistance plays a central pathogenetic role, NAFLD is regarded as the hepatic feature of the metabolic syndrome. Type 2 diabetes mellitus and obesity are the conditions most frequently associated with NAFLD. Subclinical inflammation has been suggested as a possible connective mechanism between glycoregulation disorders and NAFLD. The purpose of our study was to evaluate the prevalence and severity of glycoregulation disorders (impaired glucose tolerance and type 2 diabetes mellitus) in patients with ultrasonographical certified NAFLD, and to determine medium levels ofC reactive protein in these individuals. MATERIAL AND METHODS: The study was conducted on 104 patients with ultrasonographical certified steatosis, divided into two subgroups: simple steatosis and steatohepatitis, based on the elevation of hepatic enzymes. A control group of 100 subjects without ultrasonographical proof of hepatic steatosis had been used. Fasting glucose, oral glucose tolerance test and C reactive protein levels were performed for each patient. Statistical analysis was based on student t-test and Hi-square test. RESULTS: The prevalence of glycoregulation disorders was significantly higher in patients with NAFLD than in controls (p < 0.05). Patients with steatohepatitis had a significantly higher prevalence of type 2 diabetes mellitus than those with simple steatosis. Medium levels of C reactive protein were significantly higher in patients with NAFLD than in controls, respectively in subjects with steatohepatitis than in those with simple steatosis. CONCLUSIONS: NAFLD is at risk for developing glycoregulation disorders compared with controls; the severity of liver damage is correlated with an augmentation in the severity of glycoregulation disorders. Patients with NAFLD have higher levels of C reactive protein compared with controls, the medium levels C reactive protein increasing with an increase in hepatic damage.