title: Prevalence and predictors of non-alcoholic fatty liver disease as defined by the fatty liver index in a type 2 diabetes population.
abstract: OBJECTIVE
  We aimed to study the prevalence and the predictive factors of non-alcoholic fatty liver disease (NAFLD) defined by the fatty liver index (FLI) in type 2 diabetic patients (T2DM).
  
  
  METHODS
  Three hundred and eighty-one T2DM outpatients who regularly attended a Consulting Clinic in Cluj were retrospectivelly included. FLI, a surrogate steatosis biomarker based on body mass index (BMI), waist circumference (WC), triglycerides (TGL) and gammaglutamyl-transferase (GGT) was used to assess NAFLD in all patients. Anthropometric and biochemical parameters were measured. Hepatic steatosis (HS) was evaluated by ultrasonography.
  
  
  RESULTS
  NAFLD-FLI (defined as FLI>60) was correlated with HS evaluated by ultrasound (r=0.28; p<0.001). NAFLD-FLI was detected in 79% of T2DM. The prevalence of obesity in NAFLD-FLI patients was 80%. Of the patients with normal alanine aminotransferase (ALAT), 73.8 % had NAFLD. At univariate analysis, NAFLD-FLI was correlated with age (r= -0.14; p=0.007), sex (r=0.20; p<0.001), LDL cholesterol (r=0.12; p=0.032), HDL cholesterol (r = -0.13; p=0.015), ALAT (r=0.20; p<0.001) and ASAT (r=0.19; p<0.001). At multiple regression analysis, sex, ALAT and LDL-cholesterol were independent predictors of NAFLD-FLI. After logistic regression model, ALAT, LDL-cholesterol, HOMA-IR were good independent predictors of NAFLD-FLI.
  
  
  CONCLUSIONS
  NAFLD-FLI could be useful to identify NAFLD in T2DM patients. Subjects with T2DM had a high prevalence of NADLD-FLI even with normal ALAT levels. Our findings showed that sex, ALAT, LDL cholesterol and IR were significant and independent factors associated with the presence of NAFLD in T2DM subjects.
authors.affiliation: County Emergency Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Endocrinology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Cristina Alina
authors.initials: CA
authors.lastname: Silaghi
authors.affiliation: 5th Surgery Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Horatiu
authors.initials: H
authors.lastname: Silaghi
authors.affiliation: Medical Informatics and Biostatistics Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Horatiu Alexandru
authors.initials: HA
authors.lastname: Colosi
authors.affiliation: Diabetes, Nutrition and Metabolic Diseases Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Diabetes, Nutrition and Metabolic Diseases Department, Regina Maria Clinic, Cluj-Napoca, Romania.
authors.forename: Anca Elena
authors.initials: AE
authors.lastname: Craciun
authors.affiliation: 1st Internal Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Farcas
authors.affiliation: Diabetes, Nutrition and Metabolic Diseases Department, County Clinic Emergency Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Daniel Tudor
authors.initials: DT
authors.lastname: Cosma
authors.affiliation: Diabetes, Nutrition and Metabolic Diseases Department, Regina Maria Clinic, Cluj-Napoca, Romania.
authors.forename: Nicolae
authors.initials: N
authors.lastname: Hancu
authors.affiliation: Service Hépatogastroentérologie, Hôpital Pitié - Salpêtrière, Université Pierre et Marie Curie, INSERM UMRS 938, Paris, France.
authors.forename: Raluca
authors.initials: R
authors.lastname: Pais
authors.affiliation: Endocrinology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Carmen Emanuela
authors.initials: CE
authors.lastname: Georgescu
keywords: fatty liver index; nonalcoholic fatty liver disease; risk factors; type 2 diabetes