title: Not only type 2 diabetes but also prediabetes is associated with portal inflammation and fibrosis in patients with non-alcoholic fatty liver disease.
abstract: OBJECTIVE
  Growing evidence suggests that not only type 2 diabetes (T2D) but also prediabetes (PD) is common in patients with non-alcoholic fatty liver disease (NAFLD). However, few data exist on how PD impacts the histological characteristics of NAFLD patients. In this exploratory study, we sought to investigate the associations of PD and T2D with the severity of the histological features in patients with NAFLD.
  
  
  METHODS
  The population consisted of 280 patients with biopsy-proven NAFLD. The associations of PD and T2D with the severity of histological features of NAFLD were analyzed using multiple logistic (or ordinal logistic) regression models after adjustment for confounding factors.
  
  
  RESULTS
  PD and T2D was noted in 102 (36.4%) and 92 (32.8%) of patients, respectively. Of the 92 patients with T2D, ten (10.9%) were diagnosed de novo after the OGTT. PD and T2D were significantly associated with more severe portal inflammation (P<0.01); the adjusted odds ratios (ORs) of PD and T2D for having a higher grade of portal inflammation were 1.8 [95% CI, 1.1, 3.2] and 2.6 [95% CI, 1.3, 5.8]), respectively. A similar relationship was observed for liver fibrosis (P<0.001); specifically, the adjusted ORs of PD and T2D for having a higher grade of hepatic fibrosis were 2.4 [95% CI, 1.3, 3.7] and 3.8 [95% CI, 1.9, 6.1]), respectively.
  
  
  CONCLUSIONS
  Not only T2D but also PD is independently associated with portal inflammation and fibrosis in NAFLD patients. PD may be useful as a clinical indicator of patients who are likely to have already more severe histological findings.
authors.affiliation: Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey; Institute of Gastroenterology, Marmara University, Istanbul, Turkey. Electronic address: dryusufyilmaz@gmail.com.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yilmaz
authors.affiliation: Department of Gastroenterology, Dicle University, School of Medicine, Diyarbakir, Turkey.
authors.forename: Ebubekir
authors.initials: E
authors.lastname: Senates
authors.affiliation: Department of Gastroenterology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Atakan
authors.initials: A
authors.lastname: Yesil
authors.affiliation: Department of Radiology, Marmara University, School of Medicine, Istanbul, Turkey.
authors.forename: Rabia
authors.initials: R
authors.lastname: Ergelen
authors.affiliation: Department of Gastroenterology, Istanbul Medeniyet University, Medical Faculty, Istanbul, Turkey.
authors.forename: Yasar
authors.initials: Y
authors.lastname: Colak
mesh_terms: D000328:Adult; D001706:Biopsy; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000453:epidemiology*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000453:epidemiology; D011169:Portal Vein / Q000473:pathology*; D011236:Prediabetic State / Q000150:complications* / Q000453:epidemiology; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Clinical study; Fibrosis; Non-alcoholic fatty liver disease; Prediabetes