ArticleJournal of endocrinological investigation2021
Prevalence of hepatic steatosis in patients with type 2 diabetes and response to glucose-lowering treatments. A multicenter retrospective study in Italian specialist care.
Article in Journal of endocrinological investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Comparative effectiveness of subcutaneous GLP-1 receptor agonists versus SGLT2 inhibitors on metabolic and hepatic outcomes in T2DM with MASLD: a propensity score-matched study.Journal of endocrinological investigation · 2026Article
- Epidemiological and socio-economic burden of MASH (previously known as NASH) in Europe: a systematic literature review.Journal of endocrinological investigation · 2026Review
- Stratifying cardiovascular benefits from GLP-1RA: a multisource analysis of patient-level CVOT and real-world data using AI-driven methods.Cardiovascular diabetology · 2025Article
- Diagnosis and Monitoring of Metabolic Dysfunction Associated with Fatty Liver Disease in Primary Care Patients with Risk Factors-EsteatoGal Study.Journal of clinical medicine · 2025Article
- Article
- Mulberry Twig Alkaloids Improved the Progression of Metabolic-Associated Fatty Liver Disease in High-Fat Diet-Induced Obese Mice by Regulating the PGC1α/PPARα and KEAP1/NRF2 Pathways.Pharmaceuticals (Basel, Switzerland) · 2024Article
- A Cross-sectional Real-life Study of the Prevalence, Severity, and Determinants of Metabolic Dysfunction-associated Fatty Liver Disease in Type 2 Diabetes Patients.Journal of clinical and translational hepatology · 2023Article
- Canagliflozin and Metabolic Associated Fatty Liver Disease in Patients With Diabetes Mellitus: New Insights From CANVAS.The Journal of clinical endocrinology and metabolism · 2023Article
- The tyrosine kinase inhibitor Dasatinib reduces cardiac steatosis and fibrosis in obese, type 2 diabetic mice.Cardiovascular diabetology · 2023Article
- Hepatic steatosis with significant fibrosis is associated with an increased 10-year estimated risk of cardiovascular disease in adults with type 1 diabetes mellitus.Cardiovascular diabetology · 2023Article
- Metabolic Dysfunction-associated fatty liver disease and incident heart failure risk: the Kailuan cohort study.Diabetology & metabolic syndrome · 2023Article
- Metabolic dysfunction-associated fatty liver disease increases risk of chronic kidney disease: a systematic review and meta-analysis.eGastroenterology · 2023Article
- High Prevalence of Severe Hepatic Fibrosis in Type 2 Diabetic Outpatients Screened for Non-Alcoholic Fatty Liver Disease.Journal of clinical medicine · 2023Article
- Liver Inflammation Is Common and Linked to Metabolic Derangements in Persons With Treated Human Immunodeficiency Virus (HIV).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- A Study of Biomarkers Associated with Metabolic Dysfunction-Associated Fatty Liver Disease in Patients with Type 2 Diabetes.Diagnostics (Basel, Switzerland) · 2022Article
- Potential biomarkers in the fibrosis progression of nonalcoholic steatohepatitis (NASH).Journal of endocrinological investigation · 2022Article
- Association Between Metabolic Dysfunction-Associated Fatty Liver Disease and Cardiovascular Risk in Patients With Rheumatoid Arthritis: A Cross-Sectional Study of Chinese Cohort.Frontiers in cardiovascular medicine · 2022Article
- Transposition of cardiovascular outcome trial effects to the real-world population of patients with type 2 diabetes.Cardiovascular diabetology · 2021Article
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Authors and funding
6 authors.
Funding
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Abstract
aimType 2 diabetes (T2D) is a risk factor for metabolic dysfunction-associated fatty liver disease (MAFLD), which is becoming the commonest cause of chronic liver disease worldwide. We estimated MAFLD prevalence among patients with T2D using the hepatic steatosis index (HSI) and validated it against liver ultrasound. We also examined whether glucose-lowering medications (GLM) beneficially affected HSI.
methodsWe collected data from 46 diabetes clinics (n = 281,381 T2D patients), extracted data to calculate HSI and validated it against ultrasound-detected hepatic steatosis. We then examined changes in HSI among patients with a follow-up visit within 1 year after initiating newer GLMs.
resultsMAFLD (defined by HSI > 36, i.e., a high probability of steatosis) was present in 76.3% of the 78,895 included patients, while only 2.7% had HSI < 30 (low probability of steatosis). After age- and sex-adjusting, higher HSI was associated with higher prevalence of chronic kidney disease (odds ratio 1.35; 95%CI 1.22-1.51) and macroangiopathy (odds ratio 1.18; 95%CI 1.07-1.30). Among 2,179 subjects in the validation cohort, the prevalence of MAFLD was 67.8% and was greater in those with high HSI. Performance of HSI for ultrasound-detected MAFLD was moderate (AUROC 0.70), yet steatosis prevalence was > threefold higher among subjects with HSI > 36 than among those with HSI < 30. Notably, HSI declined significantly ~ 6 months after initiation of dapagliflozin or incretin-based therapies, but not gliclazide.
conclusionAbout three quarters of patients with T2D have HSI values suggestive of MAFLD, a condition associated with macroangiopathy and nephropathy. Treatment with dapagliflozin or incretin therapies might improve MAFLD in T2D.
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