Nonalcoholic fatty liver disease (NAFLD) is associated with both type 2 diabetes (T2DM) and congestive heart failure (CHF). T2DM is highly prevalent in CHF patients; however, the single and joint associations of T2DM and CHF with NAFLD have not been investigated yet. This issue therefore is addressed in the present study. We investigated 202 patients with CHF and 670 controls who did not have signs or symptoms of CHF and in whom significant coronary artery disease was ruled out angiographically. The presence of NAFLD was determined using the validated fatty liver index (FLI). The prevalence of T2DM was 47.0% in CHF patients and 22.1% in controls (p<0.001). FLI and prevalence of NAFLD (FLI≥60) in non-CHF subjects without T2DM were 49±28 and 38.6%, respectively. They were significantly higher in non-CHF T2DM patients (70±25, p<0.001 and 68.5%, p<0.001, respectively), in CHF patients without T2DM (63±23, p<0.001 and 58.6%, p<0.001, respectively) and in CHF patients with T2DM (73±24, p<0.001 and 78.0%, p<0.001, respectively). In multivariate analysis of covariance, T2DM and CHF proved to be mutually independent predictors of FLI after adjustment for age, sex, BMI, LDL-C, history of smoking and hypertension (F=21.47; p<0.001 and F=53.92; 0<0.001, respectively); concordantly, T2DM and CHF independently predicted the presence of NAFLD in logistic regression analyses, with adjusted odds ratios of 2.49 [1.55-3.99]; p<0.001 and 6.97 [3.95-12.29]; p<0.001, respectively.
We conclude that T2DM and CHF are mutually independent predictors of NAFLD.
M. Maechler: None. A. Vonbank: None. B. Larcher: None. A. Mader: None. L. Sprenger: None. A. Leiherer: None. D. Purin: None. A. Muendlein: None. H. Drexel: None. C.H. Saely: None.