Are Patients of Type 2 Diabetes at Greater Risk of Cirrhosis and Liver Cancer?

According to one of the recent studies, people with type 2 diabetes have higher chances of getting liver cirrhosis and liver cancer.

Diabetic patients should on and off consult a doctor for monitoring of their liver’s condition as a risk for developing life-threatening liver cirrhosis and cancer is great in these cases. This was the result researchers reached in a large study of 82 million adults living in Europe.

Another research found out that patients who had developed cirrhosis and liver cancer were already at an advanced stage during their diagnosis.

Researchers of the Queen Mary University of London and the University of Glasgow both located in the UK took part in the research. The findings of the research paper “Risks and clinical predictors of cirrhosis and hepatocellular carcinoma diagnoses in adults with diagnosed NAFLD: real-world study of 18 million patients in four European cohorts” is published in the journal BMC Medicine.

The main objective of the research was to conclude the risk of developing liver cirrhosis and cancer in those people who also have nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH).

Most of the cases of liver disease reported are of NAFLD. Its global ubiquity has increased from 15% to 25% in the past 10 years. It is spreading like the health conditions of type 2 diabetes and obesity. Only a few people are affected by this condition. However, some people will continue to develop an aggressive form of the disease called NASH. This would not only damage the liver but will also increase the chances of cancer.

Why the diagnosis of NAFLD needs to be early as soon as possible?

As people with NAFLD or NASH have greater chances of developing life-threatening diseases, a diagnostic test should be performed early so that the treatment could be started as soon as possible to bring effective results.

Senior researcher and author Dr. William Alazawi, consultant and a reader in hepatology at the Queen Mary University of London, said that doctors may not be diagnosing the NAFLD at its early stages.

After analyzing the electronic health records of 82 million people, researchers were shocked to see that very few people are diagnosed properly for NAFLD as very low rates for NAFLD were observed.

Dr. Alazawi said it is because “many patients are actually undiagnosed in primary care.” He further added, “Even over the short time frame of the study, some [people] progressed to more advanced, life-threatening stages of the disease, suggesting that they are being diagnosed very late.”

According to the data given by an American institution, the American Liver Foundation, approximately 100 million people in the United States are affected by NAFLD.

Liver of a healthy person consists of some fat but if this amount exceeds more than 5% to 10% of the total organ weight than the person develops a condition known as NAFLD where its liver is now called as fatty liver (steatosis). NAFLD does not have any link with alcohol consumption.

NASH is an advanced form of NAFLD where the liver gets inflamed and in worse conditions, the person may develop cirrhosis, liver failure, and even cancer.

There are greater chances for women to step up to this advanced stage than men. It is usually observed in the people aging between 40 to 60 years old. Only 1 out of 6 people will develop NASH from NAFLD. In most of the cases, people make a late diagnosis of the condition and live years with it.

Is diabetes the main cause of liver disease?

Dr. Alazawi studied electronic records of 18,782,281 individuals from the Netherlands, UK, Spain, and Italy. From these records, they found out that 136,703 people had been diagnosed with NAFLD or NASH. They were then matched with 100 people of the control group who did not receive such a diagnosis. The data was matched on the basis of the location of practice, date of visit, age, and sex.

The research revealed that the control group had a higher risk for the diagnosis of cirrhosis by 4.73 times compared to the group who had NAFLD or NASH. The risk threshold for receiving the cancer diagnosis was almost 3.51 or higher.

As per the analysis of the study, the “strongest independent predictor of a diagnosis” of liver cancer and cirrhosis is to have type 2 diabetes at its baseline.

It also revealed that within a few years’ people who had developed conditions of NAFLD and NASH started having a diagnosis of more life-threatening and severe liver health conditions. The researchers also revealed in their proposed study that NAFLD and NASH do not take longer time to progress to life-threatening diseases such as advanced liver disease.

This suggests that in Europe, by the time people receive the diagnosis of NAFLD and NASH, their liver could be in the stage of advanced liver cancer or any severe disease.

Dr. William Alazawi concluded it by saying, “People living with diabetes are at increased risk of more advanced, life-threatening stages of the [liver] disease, suggesting that we should be focusing our efforts [on] educating and preventing liver disease in [people with diabetes].”

Adeena Tariq

Adeena's professional life has been mostly in hospital management, while studying international business in college. Of course, she now covers topics for us in health.

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