Comment:
A recent pilot study found that elderly individuals (over 65 years of age) with type 2 diabetes mellitus (T2DM) are at a significantly higher risk of developing NAFLD and advanced fibrosis. However, this finding requires further validation before systematic screening of this patient population can be recommended by practice guidelines.
The aim of this prospective cohort study was to assess the prevalence of NAFLD, advanced fibrosis, and cirrhosis in 524 older patients (between 50-80 years old) with T2DM.
Key learnings:
In this population of older individuals with T2DM, the prevalence of NAFLD, advanced fibrosis, and cirrhosis was found to be 65%, 14%, and 6%, respectively.
Furthermore, obesity and insulin use were found to significantly increase the risk of developing NAFLD and advanced fibrosis in this patient population. The prevalence of NAFLD increased from 55.5% in non-obese to 72.6% in obese participants, and from 8.1% in non-obese to 18.2% in obese patients in the case of advanced fibrosis.
These findings highlight older patients with T2DM’s increased risk of developing advanced fibrosis, cirrhosis, and ensuing liver-related morbidity and mortality. Systematic screening of this patient population should thus be incorporated into NAFLD management guidelines.
