Indices of liver fibrosis tied to diabetic peripheral neuropathy in type 2 diabetes

In people with type 2 diabetes, liver fibrosis, measured according to indices, may be associated with diabetic peripheral neuropathy (DPN), a recent study has found.

The researchers conducted an observational analysis of 264 type 2 diabetes patients (mean age 59.4 years, 60.2 percent men) for whom the nonalcoholic fatty liver disease (NAFLD) liver fat, NAFLD fibrosis, and Fibrosis-4 (FIB-4) index scores were calculated. The Michigan Neuropathy Screening Instrument-Physical Examination (score ≥2.5) was used to diagnose DPN.

A total of 101 participants were found to have DPN, yielding a prevalence rate of 38.2 percent. Suspected NAFLD, based on an NAFLD liver fat score > –0.640, was identified in 73.3 percent and 69.3 percent of participants with vs without DPN (p=0.493). In contrast, both NAFLD fibrosis and FIB-4 index scores were significantly higher in DPN participants.

Logistic regression analysis confirmed that the NAFLD fibrosis score was significantly associated with DPN (adjusted odds ratio [aOR], 1.474, 95 percent confidence interval [CI], 1.055–2.058), as was FIB-4 index score (aOR, 1.961, 95 percent CI, 1.209–3.183). On the other hand, NAFLD liver fat score was not significantly correlated with DPN.

However, despite such correlations, the discriminative power of NAFLD fibrosis score and FIB-4 index, even when combined with fetuin-A levels, was insufficient for clinical deployment for the diagnosis of DPN.

“The present study suggests the need for special attention to DPN in individuals with type 2 diabetes and NAFLD, especially those with a high NAFLD fibrosis score or FIB-4 index. Future studies to investigate the molecular mechanism of the association between liver fibrosis and DPN are necessary,” the researchers said.