Nonalcoholic Fatty Liver Disease Linked to CVD in Type 2 Diabetes

Nonalcoholic fatty liver disease (NAFLD) is common in type 2 diabetes patients and is associated with a high prevalence of cardiovascular disease (CVD), according to new findings. Dr. Giovanni Targher, of "Sacro Cuore" Hospital, Negrar, Italy, and colleagues studied 2839 adult outpatients with type 2 diabetes. Main outcome measures were NAFLD, assessed by patient history and liver ultrasound, and manifest vascular disease determined by patient history, record review, electrocardiogram, and echo-Doppler scanning of carotid and lower limb arteries.

Overall, 2421 of the 2839 subjects had hepatic steatosis on ultrasound and the unadjusted prevalence of NAFLD was 69.5%. The authors note that NAFLD was the most common cause (81.5%) of hepatic steatosis on ultrasound.
The prevalence of NAFLD increased with age, from 65.4% among those between the ages of 40 to 59 years to 74.6% among those 60 years of age or older. The age-adjusted prevalence of NAFLD was 71.1% and 68% in men and women, respectively.

Patients with NAFLD compared to those without NAFLD also had "remarkably (p < 0.001) higher age and sex-adjusted prevalences of coronary (26.6% versus 18.3%), cerebrovascular (20.0% versus 13.3%), and peripheral (15.4% versus 10.0%) vascular disease."

Results of logistic regression analysis revealed an association between NAFLD and prevalent CVD, independent of classical risk factors, glycemic control, medications, and metabolic syndrome features.

"These results further confirm the hypothesis that the identification of NAFLD in type 2 diabetes may help in CVD risk prediction," Dr. Targher and colleagues conclude. "Future experimental and follow-up studies are needed to elucidate the possible molecular mechanisms linking NAFLD and CVD and to determine whether NAFLD predicts the development and progression of CVD."

Diabetes Care 2007;30:1212-1218.

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FACT:
First Type 1 Patient Injected with Pig Islet Cells:  According to a press release from LCT (Living Cell Technologies) the first type 1 diabetes patient was injected successfully with porcine pancreatic islet cells. The product is called Diabecell and is being tested at the Sklifasovsky Institute in Moscow in the world’s first human clinical trials. The cells, derived from pigs, are encapsulated in a protective coating that stops the body’s immune system from rejecting them, and still allows insulin to be secreted into the blood to lower blood glucose levels. The trial will involve 6 adults who have had type 1 diabetes for at least 10 years. They will have the cells transplanted into the peritoneal cavity which is located in the abdomen. A second transplant will take place in six months. Transplanting the cells is done with laproscopy, a minimally invasive technique. The first of the six patients was succesfully injected with the cells today.   Press Release from LCT Announcing First Successful Transplant of Diabecell

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