title: Occurrence over time and regression of nonalcoholic fatty liver disease in type 2 diabetes.
abstract: This analysis was aimed to assess the incidence, regression, and correlated factors of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes, which are poorly known.
  
  
  
  Nonalcoholic fatty liver disease (defined as fatty liver index [FLI] score ≥ 60) in patients with type 2 diabetes, and related factors was investigated in a nationwide database containing information from the Italian network of diabetes clinics. A 10% variation of FLI was the cut-off considered in the analyses of a cohort of 5030 patients, which was separately conducted for those who developed, maintained, or recovered from FLI-assessed NAFLD (FLI-NAFLD) over a 3-year period.
  
  
  
  At baseline, FLI-NAFLD was diagnosed in 61.3% of patients. Within the 3-year study period, FLI-NAFLD occurred in 313 patients and remitted in 410. The FLI score remained unchanged in 4307. Body-mass index (odds ratio, 1.45 95%; confidence interval, 1.35-1.55), abdominal obesity (2.11; 1.64-2.72), low HDL cholesterol levels (1.38; 1.02-1.87), and triglycerides (1.20; 1.12-1.28) all emerged as notable negative prognostic factors for the development or maintenance of FLI-NAFLD. The regression rate of FLI-NAFLD was higher among patients who managed to partially control these factors. Male sex and established organ damage, especially kidney function (1.64; 1.12-2.42), were independent risk predictors. Unlike other diabetes complications, FLI-NAFLD was more frequent among younger patients or those with a shorter duration of diabetes.
  
  
  
  FLI-assessed NAFLD is a dynamic condition, with about 5% of diabetic patients entering or leaving the status every year. Younger male patients with insulin resistance or organ damage have a higher risk of presenting with FLI-NAFLD at baseline, developing FLI-NAFLD within 3 years, and a lower probability of regression.
authors.affiliation: Diabetes and Metabolism Unit ASL Torino 5, Chieri, Italy.
authors.forename: Carlo
authors.identifier: 0000-0002-4709-8696
authors.initials: C
authors.lastname: Giorda
authors.affiliation: Unit of Metabolic Diseases and Clinical Dietetics, "Alma Mater Studiorum" University of Bologna, Bologna, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Forlani
authors.affiliation: Diabetes and Metabolism Unit ASL Torino 5, Chieri, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Manti
authors.affiliation: Unit of Metabolic Diseases and Clinical Dietetics, "Alma Mater Studiorum" University of Bologna, Bologna, Italy.
authors.forename: Natalia
authors.initials: N
authors.lastname: Mazzella
authors.affiliation: IRCCS Casa Sollievo della Sofferenza, Unit of Internal Medicine, San Giovanni Rotondo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: De Cosmo
authors.affiliation: Center for Outcomes Research and clinical Epidemiology (CORE), Pescara, Italy.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Rossi
authors.affiliation: Center for Outcomes Research and clinical Epidemiology (CORE), Pescara, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
authors.affiliation: Department of Clinical and Experimental Medicine, Policlinico Universitario "G. Martino", Messina, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Russo
authors.affiliation: AUSL Diabetes Unit Romagna, Ravenna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Bartolo
authors.affiliation: Institut d'Investigacions Biomèdiques August PiiSunyer (IDIBAPS) and Centro de Investigación Biomédicaen Red de Diabetes y Enfermeda des Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.|IRCCS MultiMedica, Milano, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ceriello
authors.affiliation: Statistical Consultant for AMD c/o Associazione Medici Diabetologi, Rome, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Guida
authors.affiliation: AMD (Italian Association of Clinical Diabetologists), Rome, Italy.
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000453:epidemiology*; D012075:Remission, Spontaneous; D012307:Risk Factors; D055105:Waist Circumference / Q000502:physiology
keywords: associated factors; hepatic steatosis; incidence; longitudinal analysis; recovery; type 2 diabetes