Nonalcoholic fatty liver disease (NAFLD) is associated with both type 2 diabetes mellitus (T2DM) and congestive heart failure (CHF) , and T2DM is highly prevalent in CHF patients, in particular among women. However, the single and joint associations of T2DM and CHF with NAFLD in women have not been investigated yet. This issue therefore is addressed in the present study.

We investigated 76 female patients with CHF and 321 female 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 39.5% in women with CHF and 22.1% in controls (p=0.002) . FLI values and prevalence rates of NAFLD (FLI≥60) in non-CHF women without T2DM were 43±28 and 31.6%, respectively. They were significantly higher in non-CHF, but T2DM patients (65±28, p<0.0 and 64.8%, p<0.001, respectively) , in CHF patients without T2DM (67±25, p<0.0 and 63.0%, p=0.002, respectively) and in CHF patients with T2DM (66±31, p<0.0 and 66.7%, 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 and use of statins (F=7.25; p=0.0 and F=46.89; p<0.001, respectively) ; concordantly, T2DM and CHF independently predicted the presence of NAFLD in logistic regression analyses, with adjusted odds ratios of 3.22 [1.38-7.50]; p=0.0 and 21.71 [6.58-71.59]; p<0.001, respectively.

We conclude that CHF and T2DM are mutually independent predictors of NAFLD in women.


M.Maechler: None. L.Sprenger: None. A.Mader: None. B.Larcher: None. A.Vonbank: None. A.Leiherer: None. A.Muendlein: None. H.Drexel: None. C.H.Saely: None.

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