Liver fibrosis, steatosis heighten risk of diabetic peripheral neuropathy

In patients with type 2 diabetes mellitus (T2DM), liver steatosis and fibrosis seem to increase the likelihood of developing diabetic peripheral neuropathy (DPN), a new study has found.

The study included 520 T2DM patients (mean age 64.82±6.51 years, 43.6 percent men), in whom DPN was assessed through nerve conduction study. The noninvasive FibroTouch system was used to assess fibrosis and steatosis.

Majority (63.0 percent; n=328) of the participants had liver steatosis, while 18.1 percent (n=94) had fibrosis. Fasting insulin, C-peptide, blood pressure, uric acid insulin resistance, and liver enzyme levels were all elevated in participants with liver steatosis; similar patterns of biomarker concentrations were observed in those with fibrosis.

More than half (52.1 percent; n=271) of the participants were diagnosed with DPN, which was found to be significantly more prevalent in patients with liver steatosis (55.7 percent vs 44.9 percent; p=0.03) and liver fibrosis (61.5 percent vs 50 percent; p=0.04).

Logistic regression analysis confirmed that hepatic steatosis (odds ratio [OR], 1.48; p=0.03) was a significant risk factor for DPN, increasing its likelihood by almost 50 percent. The same was true for liver fibrosis, which had a stronger magnitude of effect (OR, 1.60; p=0.04).

However, adjusting for confounders such as age, weight, height, body mass index, and laboratory biomarkers and indicators, only liver fibrosis remained significantly correlated with DPN risk, though its effect strengthened (OR, 2.24; p=0.02).

“Due to the cross-sectional design of the study, the causal relationship between NAFLD and DPN cannot be determined, but the preliminary correlation of nonalcoholic fatty liver disease and the presence of DPN in T2DM individuals is still significant,” the researchers said. “Thus, future prospective studies and the underlying mechanism of the correlation between DPN and fibrosis needs further analysis.”