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https://doi.org/10.14300/mnnc.2025.20052

Severe steatosis predictors in non-alcoholic fatty liver disease associated with type 2 diabetes mellitus

[Internal diseases]
Alexandr Yagoda; Elena Otarievna Demurcheva; Pavel Koroy; Temirlan Ruslanovich Dudov;

The study aimed to investigate the predictors of severe steatosis in 171 patients with non-alcoholic fatty liver disease (NAFLD) associated with type 2 diabetes mellitus. In patients with NAFLD, severe liver steatosis was associated with duration of diabetes mellitus ≥6 years; parameters of glycosylated hemoglobin ≥6.6 %; glomerular filtration rate ≤91 ml/min/1.73 m2; body mass index ≥34.5 kg/m2; waist circumference ≥103 cm; blood levels of platelets ≤229х109/l; C-reactive protein ≥8 mg/l; triglycerides ≥2.0 mmol/l; low density lipoprotein ≤3.3 mmol/l; alanine aminotransferase ≥38 u/l; aspartate aminotransferase ≥34 u/l; gamma-glutamyl transpeptidase (GGT) ≥36 u/l; alkaline phosphatase ≥100 u/l; total bilirubin ≥11.7 µmol/l; vitamin D ≤15.1 ng/ml. According to multivariate logistic regression, the severe steatosis predictors were parameters like waist circumference, blood levels of GGT and vitamin D; their combination in this aspect had a sensitivity of 76.4 % and a specificity of 76.7 %. Given this, the parameters of waist circumference, serum levels of GGT and vitamin D are risk factors for severe steatosis in NAFLD associated with type 2 diabetes mellitus, which is due to their involvement in lipid accumulation processes in hepatocytes.

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Keywords: non-alcoholic fatty liver disease, type 2 diabetes mellitus, liver steatosis, vitamin D