A recent study published in ‘Obesity’ reported that type 2 diabetes can be tailored to the risk of hepatic fibrosis. The study assessed the impact of diabetes on nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) with advanced fibrosis prevalence in adults with overweight or obesity in the United States. It included 834 middle-aged patients with and without diabetes from the National Health and Nutrition Examination Survey (NHANES) database. NAFLD was defined by Fatty Liver Index (FLI) ≥ 60 or United States FLI (USFLI) ≥ 30. Moderate-to-high and high risk of advanced fibrosis was defined by fibrosis-4 index (FIB-4) ≥ 1.67 and ≥ 2.67, respectively, and NAFLD fibrosis scores > 0.676 also indicated a high risk.

The study results revealed that the prevalence of NAFLD increased with BMI. Steatosis was higher in individuals with overweight and with diabetes versus without diabetes and in individuals with obesity with DM versus without diabetes (USFLI ≥ 30: 79.9% vs. 57.6%; p < 0.01). Diabetes significantly increased the proportion of individuals at moderate-to-high risk of fibrosis (FIB-4 ≥ 1.67: 31.8% vs. 20.1%; p < 0.05). In the high risk of advanced fibrosis group (FIB-4 ≥ 2.67), the risk got doubled (3.8% vs. 7.1%). Among individuals with obesity, diabetes increased the proportion of adults with moderate and high risk of fibrosis by 1.8- and 2.5-fold, respectively. The researchers opined that diabetes added a significant risk of fibrosis to individuals with overweight or obesity, suggesting that screening is imperative in adults with DM.