The majority of liver disease cases in people with type 2 diabetes are not alcohol-related, according to the findings of a new study which examined hospital and death records in Scotland over a 10-year period. Findings from the study are published in the Journal of Hepatology.

The researchers, from the Universities of Edinburgh and Southampton, found that the liver diseases were most commonly caused by non-alcoholic fatty liver disease (NAFLD). Between 2004 and 2013 there were 6,667 and 33,624 first mentions of chronic liver disease in those with and without type 2 diabetes (T2D), respectively.

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The results showed an increased risk associated with T2D for all other times of liver diseases, including alcoholic liver disease (ALD), although more diabetes cases were proportionally associated with NAFLD. Of  the 12,497 patients who developed ALD, 1,494 (12%) had T2D, compared to 7,016 who developed NAFLD, 1,672 (24%) of which had T2D.

The analysis showed men with type 2 diabetes were 3 times more likely to have NAFLD than men without diabetes. For women, the risk of NAFLD increased by 5 times; however, there were fewer cases of diabetes and liver disease among the female population.

With the researchers obtaining their data from the National Health Service records, the strength of the study is strong. The data captured >99% of the population of Scotland, securing validation of type of diabetes, the availability of linkage to quality-assured hospital admission, cancer registration and mortality data for the whole population.

The authors write that, given the increasing prevalence of T2D and the considerable cost of hospital admissions, their findings have important implications for prevention and management of CLD.

“We have shown for the first time that type 2 diabetes is an important novel risk factor that increases numbers of hospital admissions and deaths, in people with all common chronic liver diseases,” said Professor Chris Byrne, from the University of Southampton. “Further research is now needed to determine whether all patients with type 2 diabetes should be screened for common chronic liver diseases.”

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