Although patients with Type 2 diabetes have substantially more fat in their livers than nondiabetic patients of the same weight and sex, liver fat content in diabetics is underestimated by liver enzyme levels, according to study results published in the January issue of Diabetes Care.
Anna Kotronen, MB, at the University of Helsinki in Finland and colleagues conducted the study to determine whether type 2 diabetic patients have more liver fat than age-, sex-, and body mass index (BMI)-matched nondiabetic subjects and whether liver enzymes (serum alanine aminotransferase [S-ALT] and serum aspartate aminotransferase) are similarly related to liver fat in type 2 diabetic patients and normal subjects.
Seventy type 2 diabetic patients and 70 nondiabetic subjects matched for BMI, age, and sex were studied. Liver fat content was measured using H-MR spectroscopy and body composition was measured with MRIs. Biochemical markers of insulin resistance were also measured.
According to the results, liver fat content was about 80 percent higher in the diabetics (mean 13 vs. 7.3 percent), with the discrepancy between groups widening with increasing obesity, irrespective of antihyperglycemic therapy. S-ALT underestimates liver fat in type 2 diabetic patients.
The authors said it is important to develop tools to diagnose a fatty liver in type 2 diabetic patients since nonalcoholic steatohepatitis is more common in type 2 diabetic patients than in nondiabetic subjects and can progress to cirrhosis and liver failure. Knowing a patient’s liver fat content is a critical component to choosing treatment, they added.