(HealthDay News) — For obese patients with type 2 diabetes, nonalcoholic fatty liver disease (NAFLD) is associated with an unfavorable metabolic profile, according to a study published in Diabetes Care.

Romina Lomonaco, MD, from the University of Florida in Gainesville, and colleagues examined the metabolic consequences of nonalcoholic steatohepatitis (NASH) in patients with type 2 diabetes. One hundred fifty-four obese patients were divided into 4 groups: control (no type 2 diabetes or NAFLD); type 2 diabetes without NAFLD; type 2 diabetes with isolated steatosis; and type 2 diabetes with NASH.

The researchers found that with the presence of type 2 diabetes and the development of hepatic steatosis, metabolic parameters worsened progressively, with worse hyperinsulinemia, insulin resistance, and dyslipidemia in those with NASH (P<.001). NASH correlated with more dysfunctional and insulin resistant adipose tissue compared with isolated steatosis (either as insulin suppression of plasma free fatty acids or adipose tissue insulin resistance index; both P<.03). Insulin suppression of plasma free fatty acids also correlated with hepatic steatosis and steatohepatitis severity (both P<.001). 

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Compared with other groups, among patients with type 2 diabetes and NASH, hepatic insulin sensitivity was more significantly impaired, both fasting and with increasing insulin levels within the physiological range.

“The unfavorable metabolic profile linked to NAFLD should prompt strategies to identify and treat this population early on,” the researchers wrote.


  1. Lomonaco R, Bril F, Portillo-Sanchez P, et al. Metabolic Impact of Nonalcoholic Steatohepatitis in Obese Patients With Type 2 Diabetes. Diabetes Care. 2016. doi:10.2337/dc15-1876.