Shao Jiawei, Zhou Mi, Xie Xiaoqing, Lan Shaobo
Jiawei Shao, Department of Hepatology, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province 421002, P.R. China.
Mi Zhou, Department of Dermatology, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province 421002, P.R. China.
Pak J Med Sci. 2025 Mar;41(3):902-909. doi: 10.12669/pjms.41.3.11362.
To summarize the existing evidence on the association between non-alcoholic fatty liver disease (NAFLD) and the probability of microvascular complications in Type-2 diabetes mellitus (T2DM).
PubMed, EMBASE and Scopus databases search (from inception until October 31, 2023) was done for reports with cross-sectional, cohort or case-control design that included adult participants with T2DM and a documented NAFLD status. The selected studies were required to report on at least one microvascular outcome. Studies reporting adjusted associations were included. Random-effects models were used for all analysis. The pooled effect sizes for the associations were reported as odds ratio (OR) with 95% confidence intervals (CI).
Sixteen studies were analysed. T2DM patients with associated NAFLD had similar risk of neuropathy (OR 1.08, 95% CI: 0.97, 1.21), compared to those without NALFD. NAFLD was associated with slightly lower risk of retinopathy (OR 0.86, 95% CI: 0.75, 0.98; N=10, I=82.6%) an increased incidence of nephropathy (OR 1.21, 95% CI: 1.14, 1.29; N=12, I=82.5%), compared to patients with T2DM but no NAFLD.
Diagnosis of NAFLD in patients with T2DM appears to increase the incidence of nephropathy and decrease the risk of retinopathy. Future studies are needed to confirm these observations.
总结关于非酒精性脂肪性肝病（NAFLD）与2型糖尿病（T2DM）微血管并发症发生概率之间关联的现有证据。
对PubMed、EMBASE和Scopus数据库进行检索（从建库至2023年10月31日），查找具有横断面、队列或病例对照设计的报告，这些报告纳入了患有T2DM且有记录的NAFLD状态的成年参与者。所选研究需报告至少一项微血管结局。纳入报告了校正关联的研究。所有分析均使用随机效应模型。关联的合并效应大小以比值比（OR）及其95%置信区间（CI）报告。
分析了16项研究。与无NAFLD的T2DM患者相比，伴有NAFLD的T2DM患者发生神经病变的风险相似（OR 1.08，95% CI：0.97，1.21）。与无NAFLD的T2DM患者相比，NAFLD与视网膜病变风险略低相关（OR 0.86，95% CI：0.75，0.98；N = 10，I = 82.6%），肾病发病率增加（OR 1.21，95% CI：1.14，1.29；N = 12，I = 82.5%）。
T2DM患者中NAFLD的诊断似乎会增加肾病发病率并降低视网膜病变风险。需要进一步的研究来证实这些观察结果。
