Shalini Balamurugan, Reenaa Mohan, Tresa Remya Athipozhi Thomas, Mary J Jenifer Florence, Rajalakshmi Mahendran, Jeyakumar Manavalan, Pai R Balakrishna, Sanjay Pasupathy, Muthu Gopal
The meta-analysis identified that diabetic patients with NAFLD exhibit significantly higher body mass index (BMI), glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), aspartate aminotransferase (AST), and alanine aminotransferase levels (ALT), and lower high density lipoprotein (HDL), compared with non-NAFLD counterparts. These parameters indicate that dyslipidemia, obesity, and elevated liver enzymes are key biochemical risk factors associated with NAFLD among individuals with T2DM.
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) frequently coexists with type 2 diabetes mellitus (T2DM), significantly elevating the risk of cirrhosis and hepatocellular carcinoma. This present Systematic Review and Meta-Analysis (SRMA) aims to compare liver and lipid profiles in NAFLD and non-NAFLD individuals with T2DM, focusing on biochemical parameters and clinical outcomes.
METHODS: We searched for studies published from January 2004 to December 2024 for reporting NAFLD with diabetes mellitus (DM) patients. Data sources, Google Scholar, PubMed, Embase, Scopus, Web of Science, and Cochrane Library, were systematically searched. The data extraction was done as per a preestablished checklist. The biochemical parameters of NAFLD patients compared with non-NAFLD were analysed using RevMan 5.4 software. Data analyses were performed from 2007 to 2023.
RESULTS: Of the total 522 identified articles on NAFLD, we included 15 in the analysis and the present review representing those 25,920 patients with DM, which were segregated into 7716 NAFLD patients and 17,757 non-NAFLD patients. Meta-analysis of these data show that the study population of NAFLD with DM patients had a statistically insignificant effect with non-NAFLD patients odds ratio (OR): 1.14 (95% confidence interval [CI]: 0.28-4.68)] and significant Q statistic (P = 0.85), 95% CI does cross the line of no effect. However, the presence of heterogeneity (I2 = 100%) was observed in the selected studies.
CONCLUSION: The meta-analysis identified that diabetic patients with NAFLD exhibit significantly higher body mass index (BMI), glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), aspartate aminotransferase (AST), and alanine aminotransferase levels (ALT), and lower high density lipoprotein (HDL), compared with non-NAFLD counterparts. These parameters indicate that dyslipidemia, obesity, and elevated liver enzymes are key biochemical risk factors associated with NAFLD among individuals with T2DM.
PROSPERO REGISTRATION NUMBER: CRD42024619079.