Aim: Nonalcoholic fatty liver disease (NAFLD) has been suggested as
independent predictor for kidney disease and proliferative retinopathy in
patients with type 2 diabetes (T2D), while the association with diabetic
polyneuropathy (DPN) is debated. The aim of this study is to evaluate the
association between DPN and predictive tools and ultrasonography diagnosis of
NAFLD.
Methods: Forty-two diabetic patients (mean age 57.83 ± 11.47 years, duration
9.44 ± 8.92 years, HbA1c 59.19 ± 13.85 mmol/mol, 27 males, 93% T2DM),
underwent clinical evaluation of DPN by Michigan Neuropathy Screening
Instrument (MNSI), Michigan Diabetic Neuropathy Score (MDNS) and Diabetic
Neuropathy Index (DNI). NAFLD was evaluated by predictive tools Fatty Liver
Index (FLI) and Hepatic Steatosis Index (HIS), and confirmed by liver
ultrasonography.
Results: DPN was present in 22 (52.4%) participants. DPN patients were older
(p=0.04) and characterized by higher prevalence of impaired urinary albumin
excretion (p=0.035), hypertension (p=0.011) and dyslipidemia (p=0.041). High risk FLI and HIS scores were detected in 81% and 64.3% of subjects, while
ultrasonography NAFLD was present in 31 out of 36 (85.7%%) patients (20 with
mild and 11 with moderate-severe grade), resulting more frequent in females
than males (93.3% versus 63.0%, p=0.032).
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No significant difference was found in DPN prevalence in patients with NAFLD
than those without (54.8 versus 45.2 %, p=0.338), also considering only high grade steatosis. No association was identified between DPN and non-invasive
predictive tools of NAFLD.
Conclusion: Although in a small sample of diabetic subjects, liver steatosis is not
independently associated with clinical diagnosis of DPN
