Wild SH, et al. - An analysis was performed to define relationships between alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD) hospital admission and cardiovascular disease (CVD), cancer, and mortality in people with type 2 diabetes mellitus (T2DM). Among people with T2DM, hospital records of ALD or NAFLD were associated to varying degrees with an increased risk of CVD, cancer, and mortality.

Methods

• From 2004 and 2013, the researchers conducted a retrospective cohort study by using linked population-based routine data from diabetes registry, hospital, cancer, and death records for people ages 40-89 years diagnosed with T2DM in Scotland who had one or more hospital admission records.
• They identified liver disease and outcomes by using ICD-9 and -10 codes.
• Hazard ratios (Hrs) were estimated from Cox proportional hazards regression models, adjusting for key risk factors.

Results

• The researchers studied 134,368 people with T2DM (1,707 with ALD and 1,452 with NAFLD), with a mean follow-up of 4.3 years for CVD and 4.7 years for mortality.
• Hospital recorded 378, 320, and 21,873 CVD events, among those with ALD, NAFLD, or without liver disease, where 268, 176, and 15,101 cancers; and 724, 221, and 16,203 deaths were reported, respectively.
• It was found that for ALD and NAFLD, respectively, adjusted HRs (95% CIs) than the group with no record of liver disease were 1.59 (1.43, 1.76) and 1.70 (1.52, 1.90) for CVD, 40.3 (28.8, 56.5) and 19.12 (11.71, 31.2) for hepatocellular carcinoma (HCC), 1.28 (1.12, 1.47) and 1.10 (0.94, 1.29) for non-HCC cancer, and 4.86 (4.50, 5.24) and 1.60 (1.40, 1.83) for all-cause mortality.