Objective Type 2 Diabetes (T2D) is a major risk factor for the development and progression of non-alcoholic fatty liver disease (NAFLD). The published prevelance in epidemiological studies in this high risk population exceeds 70%. The aim of this analysis was to investigate the impact of NAFLD on T2D patients in Germany. Methods Using the Disease Analyzer Database (IQVIA), T2D patients with NAFLD diagnosed in Germany were matched to a cohort without NAFLD controlling for age, sex, physician, index year and metabolic comorbidities and assessed for their risk of developing myocardial infarction, stroke, peripheral arterial disease (PAD) or chronic kidney disease, as well as the type of T2D treatment on NAFLD. Results 2633 T2D patients with NAFLD were matched to 2633 T2D patients without liver disease. The ICD coded prevalence of NAFLD in patients with T2D in primary care in Germany was 7.8%. On regression analysis of patients with T2D , the presence of NAFLD was associated with a higher risk of renal failure during follow-up (HR 1.17, 95% CI 1.02–1.34, p=0.027). No association with the development of myocardial infarction, stroke, PAD or initiation of insulin therapy was observed. NAFLD patients were more frequently treated with DDP-4 inhibitors (+/-metformin) and less frequently with insulin within the first year of T2D diagnosis. The metabolic control (HbA1c range 6.5–7.5%) during follow-up did not differ between both groups. Conclusion The coded prevalence of NAFLD in T2D patients is low, which is in contrast to published series. Enhancing disease awareness of NAFLD and screening recommendations in high risk populations will be beneficial for the active management of these patients.

中文翻译：

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非酒精性脂肪肝对 2 型糖尿病代谢合并症的影响

目的 2 型糖尿病（T2D）是非酒精性脂肪肝（NAFLD）发生和进展的主要危险因素。在这一高危人群中已发表的流行病学研究流行率超过 70%。本分析的目的是调查 NAFLD 对德国 T2D 患者的影响。方法 使用疾病分析数据库 (IQVIA)，将在德国诊断为 NAFLD 的 T2D 患者与没有 NAFLD 的队列进行匹配，控制年龄、性别、医生、指数年和代谢合并症，并评估他们发生心肌梗塞、中风、外周疾病的风险动脉疾病 (PAD) 或慢性肾脏疾病，以及 NAFLD 的 T2D 治疗类型。结果 2633 名患有 NAFLD 的 T2D 患者与 2633 名无肝病的 T2D 患者相匹配。德国初级保健中 T2D 患者的 ICD 编码 NAFLD 患病率为 7.8%。在对 T2D 患者的回归分析中，NAFLD 的存在与随访期间肾功能衰竭的较高风险相关（HR 1.17, 95% CI 1.02–1.34, p=0.027）。未观察到与心肌梗塞、中风、PAD 或开始胰岛素治疗的发生相关。NAFLD 患者在 T2D 诊断的第一年内更频繁地接受 DDP-4 抑制剂（+/-二甲双胍）治疗，而较少接受胰岛素治疗。随访期间的代谢控制（HbA1c 范围 6.5-7.5%）在两组之间没有差异。结论 T2D 患者中 NAFLD 的编码患病率较低，这与已发表的系列文章形成鲜明对比。