Introduction: Nonalcoholic steatohepatitis (NASH) associated with type 2 diabetes (T2D) increases the risk for cardiovascular disease, cirrhosis and hepatocellular carcinoma. Several clinical predictors of NASH are known but gender differences in subjects with T2D are unknown.
Aims: To determine gender differences in clinical predictors of NASH in Asian Indians with T2D.
Methods: This one-year prospective study was conducted after institutional approval and informed consent. Recruited participants had no history of liver disease, hepatotoxic drugs or alcohol intake. Transient elastography by FibroScan, validated for diagnosis of fibrosis by liver stiffness measurement (LSM), was used in this study. NASH was diagnosed when LSM was ≥7 kPa.
Results are tabulated below.
Conclusions: In subjects with T2D, women had significantly higher prevalence of NASH (34.7%) compared to men (26.3%), with a 50% higher risk. Obesity, hypertriglyceridemia and hypoalbuminemia were strong predictors of NASH in both genders. Systolic hypertension doubled the risk in women but was not significant in men, while hyperglycemia was a significant predictor in men but not in women. Raised Waist/Height Ratio conferred much higher risk of NASH in women compared to men, while the high risk due to raised BMI and waist circumference was similar in both genders. Predictors of NASH are crucial targets for intervention but vary by gender.
S. Panicker: Speaker's Bureau; Self; Abbott, AstraZeneca, Biocon, Dr. Reddys Laboratories, Eli Lilly and Company, Intas Pharmaceuticals Ltd., Johnson & Johnson, Novartis AG, Novo Nordisk A/S, Sanofi India Pvt Ltd; Speaker's Burea; Self; SUN Pharma Self.J.W. Stephens: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, NAPP Pharmaceuticals Limited.