Liver fat leads to diabetes in a third of adults – 04/14/2023 – Equilibrium and Health

One-third of adults over age 35 have fatty liver and are at increased risk of developing type 2 diabetes.

In addition, the chance of having a diagnosis of diabetes due to the accumulation of fat in the liver was about 38% higher in women and 29% higher in people with a high waist circumference.

The study was the first to characterize non-alcoholic fatty liver disease (or Nafld) as a risk factor for diabetes, which is growing in Brazil. It was conducted by researchers from UFMG (Federal University of Minas Gerais), Hospital das Clínicas of UFMG, UFRGS (Federal University of Rio Grande do Sul) and USP (University of São Paulo).

The article was published this Friday (14) in the journal Cadernos de Saúde Pública.

To assess the incidence of diabetes in the population, the scientists analyzed data from the ELSA (longitudinal study of adult health), a survey initiated in 2008 by universities and a research institute in six capitals in the country: UFMG (Belo Horizonte), Ufes (Universidade Federal do Espírito Santo – Vitória), USP (Sao Paulo), UFBA (Federal University of Bahia – Salvador), UFRGS (Porto Alegre) and Fiocruz (Oswaldo Cruz Foundation – Rio de Janeiro).

In total, 8,166 participants, chosen from active or retired employees of these sites aged 35 to 74 years, were followed over a period of three years.

According to the survey, 35.1% of participants were diagnosed with fatty liver, or fatty liver. Of these, 20% had the so-called steatohepatitis, a non-alcoholic inflammation also known as Nash.

The prevalence of hepatic steatosis was higher in individuals with low education (41% in those who had completed elementary school versus 33.4% in those with higher education) and in people who were overweight (44%) or obese (34.5% ).

The presence of fat in the liver increased the risk of developing diabetes by 30%, according to the study. The cumulative incidence of diabetes (number of diagnoses divided by the total number of participants over time) was 5.25% in the general population. In individuals with fatty liver disease, the observed incidence was 7.83%, against 3.88% in those without fat accumulation.

For Luciana Costa Faria, gastroenterologist and professor of hepatology at the UFMG Faculty of Medicine, the discovery of hepatic steatosis as a risk factor for diabetes is worrying because it may also be associated with other health problems, such as hypertension and changes in cholesterol. “We now know that individuals with fatty liver disease will not die from it, but they have high mortality from cardiovascular disease, and both diabetes and other components increase the risk of heart problems,” she explains.

Hepatic steatosis can be diagnosed through imaging tests, such as ultrasound, but patients often seek the test to investigate another condition. “In general, people find fat in the liver and think it’s just fat in the liver, but that’s not quite the case. In one fifth of cases it progresses to steatohepatitis, which already presents lesions and inflammation of the organ, and in 20% these cases can progress to liver fibrosis or cirrhosis”, he says.

As liver fat is reversible by changing lifestyle habits and losing weight, Faria explains that it is better to try to contain the signs of the disease before progression occurs.

“The loss of 5% of weight can already lead to the regression of steatosis, while it is necessary to lose 7% to 10% to reduce steatohepatitis or fibrosis. Fat in the liver can be reversed and even act by reducing the risks of developing diabetes and other health problems”, he explains.

A diet rich in natural foods and regular physical activity are good ways to avoid fat accumulation. “Eating badly, with high consumption of ultra-processed foods, and a sedentary lifestyle are risk factors not only for steatohepatitis but also for cardiovascular diseases, such as heart attacks and strokes, and cancer”, he says.