Non-alcoholic fatty liver disease is independently associated with an increased prevalence of chronic kidney disease and proliferative/laser-treated retinopathy in type 2 diabetic patients.

Abstract

Aims/hypothesis Non-alcoholic fatty liver disease (NAFLD)is associated with an increased risk of cardiovascular diseasein type 2 diabetes. Currently, there is a lack of informationon associations between NAFLD and microvascular complicationsof diabetes. We assessed the associations between NAFLD and both chronic kidney disease (CKD) and retinopathy in a large cohort of type 2 diabetic individuals using a cross-sectional design.Methods Prevalence rates of retinopathy (by ophthalmoscopy)and CKD (defined as overt proteinuria and/or estimated GFR 6460 ml min 121 1.73 m 122) were assessed in 2,103 type 2diabetic individuals who were free of diagnosed cardiovasculardisease and viral hepatitis. NAFLD was ascertained by patient history, blood sampling and liver ultrasound.Results NAFLD patients had higher (p<0.001) age- andsex-adjusted prevalence rates of both non-proliferative (39vs 34%) and proliferative/laser-treated retinopathy (11 vs5%), and CKD (15 vs 9%) than counterparts without NAFLD.In logistic regression analysis, NAFLD was associated withincreased rates of CKD (odds ratio 1.87; 95% CI 1.3\u20134.1,p=0.020) and proliferative/laser-treated retinopathy (oddsratio 1.75; 1.1\u20133.7, p=0.031) independently of age, sex,BMI, waist circumference, hypertension, diabetes duration,HbA1c, lipids, smoking status and medications use.Conclusions/interpretation Our findings suggest that NAFLDis associated with an increased prevalence of CKD and proliferative/laser-treated retinopathy in type 2 diabetic individuals independently of numerous baseline confounding factors. Further studies are required to confirm the eproducibilityof these results and to evaluate whether NAFLD contributes to the development or progression of CKD and retinopathy