A new research presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD), identified a link between larger waistlines and the progression of non-alcoholic fatty liver disease (NAFLD) in people with type 2 diabetes. The study was conducted in 684 T2D patients with an average age of 61, a BMI of 28.7 and a waist circumference of 104cm. 59% were male. Patients underwent fibrosis screening using Vibration-controlled transient elastography scans (a form of ultrasound) with liver fibrosis staged according to liver stiffness measurement (LSM) for significant fibrosis (LSM 8 kPa; 22.5%), advanced fibrosis (LSM 10 kPa; 12.4%) and cirrhosis (LSM 15 kPa; 3.8%).

The analysis showed that 24.8% of the participants had macrovascular complications of T2D, such as heart disease. 20.5% had retinopathy; 39.4% had neuropathy; and 38.3% had nephropathy. It also revealed nephropathy to be significantly more common in those with advanced fibrosis than the other T2D patients. 52.1% of those with advanced fibrosis had nephropathy, compared to 36.3% of the other T2D patients. Rates of the other complications (macrovascular, retinopathy and neuropathy) did not differ between those with advanced fibrosis and the other T2D patients. The study also found that every 1cm increase in waistline was associated with a 5% increase in the likelihood of the participants developing advanced fibrosis.

The researchers concluded that doctors treating people with type 2 diabetes should be aware of these links and check for advanced fibrosis when their waist circumference or level of AST is high.