Author(s)

Comlan Jules Gninkoun^1*, Sylvie A. Ahn², K. Daniel Amoussou-Guenou³, Evariste Bouenizabila⁴, Michel F. Rousseau², Michel P. Hermans⁵

¹Service d’Endocrinologie & Diabétologie, Faculté des Sciences de la Santé, Cotonou, Bénin.
²Division of Cardiology, Cliniques Universitaires St-Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
³Departmental Hospital and University Centre, Service de Médecine interne-Endocrinologie, CHUD/OP Porto-Novo, Université d’Abomey-Calavi, Abomey-Calavi, Bénin.
⁴Service de Maladies Métaboliques et Endocriniennes, Centre Hospitalier et Universitaire de Brazzaville, Brazzaville, Congo.
⁵Division of Endocrinology & Nutrition, Cliniques universitaires St-Luc and Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.

Purpose: Non-alcoholic fatty liver (NAFL) is comorbid to obesity, metabolic syndrome and type 2 diabetes mellitus (T2DM). It is unclear whether NAFLD constitutes a direct risk factor for macrovascular disease in T2DM. This study aimed at revisiting the cardiometabolic traits linked to NADL and micro-/ macrovascular complications in a biethnic Caucasian and African cohort. Methods: Cross-sectional analysis of 568 of T2DM patients (515 Caucasians; 53 Africans) in whom the presence of NAFL was identified by ultrasonography and the cardiometabolic phenotype was exhaustively characterized, including carbohydrate homeostasis, comprehensive lipidogram including Lp(a), cumulative exposure to hyperglycemia, and prevalent micro/macrovascular complications. Results: FL was present in 73% of Caucasians and 36% of Africans (p < 0.0001). FL+ were more obese, more atherogenic dyslipidemic (Caucasians) and had lower lipoprotein(a) (Africans). All-cause macroangiopathy, ischemic heart disease or stroke did not significantly differ between FL+ and FL− in both groups. A marked reduction in diabetic retinopathy (DR), ocular hypertonia and cataracts were found in FL+ of the two ethnicities. In FL+ Caucasians, relative risk of DR was −38%, cataracts −35%, and ocular hypertonia −42%. In FL+ Africans, risk of overall microangiopathy was −66% and that of DR −86%. Conclusions: An inverse association was observed between NAFL and the presence of diabetic retinopathy, cataract and ocular hypertonia. The ophthalmoprotection conferred by liver steatosis was found in Caucasians and Africans. Among the latter, hepatic steatosis was linked to lower lipoprotein(a) levels. There was no association between hepatic steatosis and prevalent macrovascular complications in neither of the two ethnic groups.

Fatty Liver, Type 2 Diabetes, Microangiopathy, Retinopathy, Coronary Artery Disease, Lipoprotein(a)

Gninkoun, C. , Ahn, S. , Amoussou-Guenou, K. , Bouenizabila, E. , Rousseau, M. and Hermans, M. (2020) Fatty Liver Linked to Reduced Frequency of Ocular Complications in T2DM. Journal of Diabetes Mellitus, 10, 154-168. doi: 10.4236/jdm.2020.103013.