As the prevalence and clinical characteristics of non-alcoholic fatty liver disease (NAFLD) are still unknown in ketosis-onset diabetes, the present study compared the characteristics of NAFLD in type 1 diabetes (T1D), ketosis-onset and non-ketotic type 2 diabetes (T2D) patients.

Ketosis-prone diabetes is defined as newly occurred diabetes, having typical polydipsia, polyuria, polyphagia, and extenuation within 6 months; ketosis (urine ketone body above 2+) or ketoacidosis no more than 6 months after onset. Both of the two groups should match the condition that there are no obvious incentives such as infection, surgery, and trauma; pregnancy diabetes, drug and pancreatic exocrinosity diseases, and endocrine diseases caused secondary diabetes were excluded. However, the prevalence and clinical characteristics of non-alcoholic fatty liver disease (NAFLD) are still incomprehensible in ketosis-onset diabetes. The present study compared the characteristics of NAFLD in type 1 diabetes (T1D), ketosis-onset and non-ketotic type 2 diabetes (T2D) patients.

The outcome revealed that prevalence of NAFLD in patients with ketosis-onset diabetes (61.8%) was remarkably higher than in controls (23.3%) and in T1D patients (15.4%). Nevertheless, no difference in prevalence was found between ketosis-onset and non-ketotic T2D patients (52.6%). BMI and alanine aminotransferase (ALT) were also found to be independent risk factors for the presence of NAFLD in both these groups, while serum uric acid levels was found to be independent risk factors in T1D patients.

Thus, the results concluded that NAFLD prevalence and risk factors found in ketosis-onset diabetes are comparable to those in non-ketotic T2D.  However, its prevalence and associated risk factors are dissimilar from those in T1D. Thus, the evidence supports the hypothesis that ketosis-onset diabetes should be categorized as a subtype of T2D, instead as idiopathic T1D.

Source: Metab. 2018 Nov;44(5):437-443.