Original Data

First-Degree Relatives of Patients with Type 2 Diabetes Mellitus and Risk of Non-Alcoholic Fatty Liver Disease

Atoosa Adibi¹, Mohsen Janghorbani^2,3, Sanaz Shayganfar¹, Masoud Amini³

Abstract

AIMS: The aim of this study was to determine whether first-degree relatives (FDR) of patients with type 2 diabetes mellitus (T2DM) are at higher risk of non-alcoholic fatty liver disease (NAFLD) than healthy controls. METHODS: A total of 222 FDR of consecutive patients with T2DM aged between 35 and 55 years and 202 healthy individuals with no family history of diabetes were investigated for NAFLD. Fatty liver was diagnosed by ultrasonography using standard criteria. Height, weight, fasting glucose, alanine aminotransferase (ALT), total cholesterol and triglyceride were determined by routine laboratory methods. RESULTS: Compared to subjects with no family history of diabetes, the age and sex adjusted odds ratio (OR) of NAFLD was 1.83 (95% CI: 1.11-3.03) for FDR of patients with T2DM. After further adjusting for BMI, fasting glucose, ALT, asparate aminotransferase (AST), triglyceride and cholesterol, the multivariate OR of prevalent NAFLD in FDR of patients with T2DM compared with individuals with no family history of diabetes was 1.56 (95% CI: 0.85-2.86). CONCLUSIONS: The present study suggests that the relation between FDR of patients with T2DM and NAFLD is affected by the other covariates, in particular obesity, which points to a more complex relationship between the diseases. It appears that obesity and diabetes may independently predispose to NAFLD.

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The Incidence of Microalbuminuria and its Associated Risk Factors in Type 2 Diabetic Patients in Isfahan, Iran

Massoud Amini, Hassan Safaei, Ashraf Aminorroaya

Abstract

AIM: The study was carried out to determine the five-year incidence of microalbuminuria and to assess its associated risk factors for type 2 diabetic patients in Isfahan, Iran. METHODS: 505 type 2 diabetic patients (22% male, 78% female) with normal urinary albumin levels, being treated at Isfahan Endocrine and Metabolism Research Center, were consecutively selected. After the initial selection in 1999, the patients were followed for five years. Mean and standard deviation (SD) of age and duration of diabetes was 57.4 (9.5) and 10.2 (4.7) years, respectively. BMI, blood pressure, fasting plasma glucose, HbA1c, serum lipids and serum creatinine were measured and re-examined every three months. 24-h urinary albumin excretion was measured and reviewed annually. Microalbuminuria was diagnosed when at least two measurements indicated the excretion of more than 30 mg albumin in 24-h urinary samples. RESULTS: During 5-year follow up, 176 patients developed microalbuminuria, giving an incidence rate of 82.3/1000 person/year (95% CI: 78.3-86.2). Males had a higher incidence than females (104.4 vs. 66.2/1000 person/year, p < 0.001). Duration of diabetes, abnormal levels of HbA1c, hypertension and high serum creatinine were significantly associated with microalbuminuria. There was no difference in mean of age, BMI, and lipid levels between patients with and without microalbuminuria. Multivariate analysis was used to show that duration of diabetes, HbA1c, hypertension and retinopathy were the independent variables related to microalbuminuria. CONCLUSIONS: The incidence of microalbuminuria in the study population was higher than in other populations. The higher incidence and the considerable gender difference in this population may be attributed to inferior glycemic control and lack in screening for risk factors, but this needs to be explored in further studies.

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