Nonalcoholic fatty liver disease (NAFLD) is independently associated with cardiovascular disease and chronic kidney disease. Among patients with type 2 diabetes (T2DM), the relationship between NAFLD and diabetic macrovascular and microvascular complications is unclear. The study population consisted of 2504 patients (M/F: 1520/984, mean age 60.8 ± 10.4 years) with T2DM who have been hospitalized between 2007 and 2011. All subjects had data on anthropometric parameters, total cholesterol (TC), low-density lipoprotein cholesterol, HbA1C, creatinine (Scr), tumor necrosis factor- α (TNF-α), and 24h urine albumin exerting rate (24hUAER). Doppler ultrasound examination was used to diagnose fatty liver and to measure carotid artery intima-media thickness (IMT). Carotid artery intimal thickening was diagnosed as IMT≧1mm. Diabetic nephropathy (DN) was diagnosed if 24hUAER≧30mg/24h. NAFLD accounted for 57.4% of all patients. After adjusting for age, gender, disease duration, systolic blood pressure (SBP), waist and other factors, patients with NAFLD had increased carotid artery IMT (1.11 ± 0.25 vs. 0.87 ±0.18 mm, P <0.001) and increased 24hUAER (27.53 ± 19.70 vs. 20.34 ± 13.92 mg/24h, P <0.01) compared with those without NAFLD. In the multivariate logistic regression model with Carotid artery intimal thickening as the dependent variable, NAFLD was an independent risk factor for IMT thickening, the corresponding OR (95% CI) was 1.89 (1.42, 2.52) after adjusting for age, gender, disease duration, waist, SBP, HbA1C, TC, and TNF-α; In the similar analysis for DN, NAFLD was also independently associated with risk of DN, with an OR (95% CI) of 1.67 (1.25, 2.26). In patients with T2DM, NAFLD is not only associated with increased risk for macro-vascular but also for micro-vascular complications. Intervention and prevention of NAFLD may be addressed for prevention of macro-vascular and micro-vascular complications.


L. Zhang: None. N. Wang: None. J. Wang: None. X. Yin: None. Y. Yang: None. W. Gao: None. Y. Dong: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at