Metabolic associated fatty liver disease in patients with type 2 diabetes mellitus

Introduction. In patients with type 2 diabetes mellitus (T2DM) and obesity, the incidence of metabolically associated fatty liver disease (MAFLD) varies from 70 to 100%, and cardiovascular diseases are five times more common. Metabolic risk factors (RF) for fatty liver disease associated with T2DM are a dangerous combination, mutually aggravate each other’s course and escalate the number of adverse outcomes. Aim. To investigate the frequency of metabolic risk factors in fatty liver disease in patients with type 2 diabetes. Materials and methods. An observational cross-sectional (one-time) study was conducted with a retrospective analysis of inpatient observation cards of patients with type 2 diabetes (n = 179). MAFLD was established in the presence of hepatic steatosis, proven by ultrasound, in a patient with type 2 diabetes in combination with two or more metabolic disorders. Results. The MAFLD phenotype in T2DM includes a high frequency of risk predictors: abdominal obesity and hypertension (100%), obesity (59.2%) and overweight (31.3%); meeting the criteria for MAFLD levels of HDL (94.4%), triglycerides (53.6%) and CRP (68.7%) in the blood plasma. Signs of sexual dimorphism were noted: in men: average age – 51.7%, more often normal (18.9%) and overweight (36.3%); most often AH in stage III (27.6%), complications include diabetic foot syndrome (3.9 times) and significant stenosis of the BCA (3 times). Elderly women (63.7%), were 1.5 times more likely to have obesity and stage III hypertension (13.2%), and suffered strokes more often than men (2.5 times). Conclusions. The impact of genetic factors and various pathogenetic processes leads to the formation of a pathological pattern with a systemic disturbance of energy balance. To reduce the individual and population risk of vascular complications, it is necessary to control each of the components of MAFLD and achieve their target values.