| Resume |
Purpose: Non-alcoholic fatty liver (NAFL) is comorbid to obesity, metabolic
syndrome and type 2 diabetes mellitus (T2DM). It is unclear whether NAFLD
constitutes a direct risk factor for macrovascular disease in T2DM. This study
aimed at revisiting the cardiometabolic traits linked to NADL and micro-/
macrovascular complications in a biethnic Caucasian and African cohort.
Methods: Cross-sectional analysis of 568 of T2DM patients (515 Caucasians;
53 Africans) in whom the presence of NAFL was identified by ultrasonography
and the cardiometabolic phenotype was exhaustively characterized, including
carbohydrate homeostasis, comprehensive lipidogram including Lp(a), cumulative exposure to hyperglycemia, and prevalent micro/macrovascular complications.
Results: FL was present in 73% of Caucasians and 36% of Africans (p
< 0.0001). FL+ were more obese, more atherogenic dyslipidemic (Caucasians)
and had lower lipoprotein(a) (Africans). All-cause macroangiopathy, ischemic
heart disease or stroke did not significantly differ between FL+ and FL− in
both groups. A marked reduction in diabetic retinopathy (DR), ocular hypertonia and cataracts were found in FL+ of the two ethnicities. In FL+ Caucasians, relative risk of DR was −38%, cataracts −35%, and ocular hypertonia−42%. In FL+ Africans, risk of overall microangiopathy was −66% and that of DR −86%.
Conclusions: An inverse association was observed between NAFL and the presence of diabetic retinopathy, cataract and ocular hypertonia. The ophthalmoprotection conferred by liver steatosis was found in Caucasians and Africans. Among the latter, hepatic steatosis was linked to lower lipoprotein(a) levels. There was no association between hepatic steatosis and prevalent macrovascular complications in neither of the two ethnic groups. |