Background: Type 2 diabetes mellitus (T2DM) is interrelated with nonalcoholic fatty liver disease (NAFLD) and liver fibrosis. However, the association between NAFLD and diabetic peripheral neuropathy (DPN) has not been well studied.
Methods: We prospectively enrolled subjects with T2DM to evaluate risk factors of DPN and to develop a screening tool of DPN. In this study, we analyzed the data of 127 subjects in whom we could calculate NAFLD and liver fibrosis scores. DPN was diagnosed using the Michigan Neuropathy Screening Instrument. Non-invasive markers of NAFLD (hepatic steatosis index, and NAFLD liver fat score) and liver fibrosis (NAFLD fibrosis score, and fibrosis-4 score) were calculated using equations containing several combinations of age, the presence of obesity or metabolic syndrome, liver function test, fasting insulin level, and platelet count. Body composition was measured by bio-impedance analysis. Clinical parameters and various markers were compared according to the presence of DPN.
Results: The prevalence of DPN in our study was 39.3%. There was no significant difference in body mass index, diabetes duration, and liver function test between subjects with DPN and those without DPN. Subjects with DPN showed older age, and higher fasting blood glucose level. Hepatic steatosis index and NAFLD liver fat score were comparable between subjects with or without DPN. In contrast, subjects with DPN showed significantly higher NAFLD fibrosis score (-0.7 vs. -1.3, P = 0.004) and fibrosis-4 score (1.6 vs. 1.2, P = 0.014) compared to those without DPN. These two scores were negatively associated with lean body mass. After adjusting lean body mass, the association between liver fibrosis scores and DPN was still significant.
Conclusion: The liver fibrosis scores but not NAFLD scores were higher in subjects with DPN compared to those without DPN. Liver fibrosis and DPN might share common pathophysiology.
K. Kim: None. T. Oh: None. Y. Shin: None. S. Choi: None. H. Jang: Speaker’s Bureau; Self; Daiichi Sankyo, Handok, Pfizer Inc., Takeda Pharmaceutical Company Limited.