Importantly, over 70% of patients with diabetes in the US concurrently possess NAFLD, a statistic evincing both diseases’ bidirectional relationship. Indeed, although type 2 diabetes (T2D) is known to promote the progression of mild hepatic steatosis into fibrosis, recent studies indicate that NAFLD increases the risk of developing T2D by up to 5-fold.
This study aimed to investigate the prevalence and association between NAFLD, race and gender in patients with prediabetes and diabetes among a nationally representative sample of adults in the US.
Compared to those in the normoglycemic group, prediabetic and diabetic patients possessed higher odds of developing and presenting with severe NAFLD. In these patient populations, one-unit increases in HbA1c were further associated with an increased risk of severe NAFLD. Moreover, racial/ethnic disparities in both male and female patients were noted in the normoglycemic group. Similarly, within the diabetic group, a racial disparity was observed in male patients. Indeed, normoglycemic and diabetic Mexican-American males were found to possess the highest prevalence of severe NAFLD relative to other racial/ethnic groups. Importantly, however, no disparities were detected in patients with prediabetes. These findings highlight the importance of screening diabetic, and importantly, prediabetic patients for NAFLD to ensure the early and effective detection of liver disease. They also support the development of interventions aimed at reducing HbA1c levels in these patient populations.