Study Finds Liver Fibrosis to be an Independent Predictor of Diabetic Peripheral Neuropathy

Microscopic photo of a professionally prepared slide demonstrating macrovesicular steatosis of the liver (fatty liver disease), hepatic steatosis, metabolic syndrome. Can be ssociated with nonalcoholic fatty liver disease (NAFLD) or Alcoholic Liver Disease (ALD). H&E stain.
Researchers evaluated the correlation of liver fibrosis and steatosis with diabetic peripheral neuropathy in patients with type 2 diabetes.

Diabetic peripheral neuropathy (DPN) was found to be more commonly diagnosed among patients with liver steatosis or fibrosis, according to the results of a study published in the Journal of Diabetes Investigation.

Researchers gathered demographic data and clinical characteristics for patients (N=520; 43.6% men) with type 2 diabetes and assessed liver health and symptoms of DPN. The mean age of participants was 65 years, mean body mass index was 24.47  kg/m2, and mean glycated hemoglobin (HbA1c) was 7.01%.

Most patients (63.0%) had liver steatosis and 18.1% had liver fibrosis. Patients with liver steatosis were heavier, had a shorter duration of diabetes, and had higher fasting insulin and C-peptide levels, as well as systolic and diastolic blood pressures (all P <.001). Patients with liver fibrosis were more likely to be women (P =.004), to be heavier (P =.03), to have higher HbA1c (P =.01), and to have higher systolic (P =.001) and diastolic (P =.001) blood pressure values.

Most patients had DPN (52.1%). Patients with DPN were more likely to be men (P <.001), younger (P =.02), heavier (P =.001), to have higher HbA1c (P <.001), and to have higher systolic (P <.001) and diastolic (P <.001) blood pressure values. Indicators of kidney, liver, and inflammatory health did not differ on the basis of DPN.

A diagnosis of DPN was made more often among patients with liver steatosis vs those without (55.7% vs 44.9%; P =.03) and among those with liver fibrosis vs those without (61.5% vs 50.0%; P =.04).

In the fully adjusted multivariate analysis, liver fibrosis was significantly associated with DPN (adjusted odds ratio [aOR], 2.24; 95% CI, 1.11-4.53; P =.02) but liver steatosis was not (aOR, 1.78; 95% CI, 0.97-3.25; P =.06).

A limitation of this study is its cross-sectional design; therefore, causal relationships could not be determined.

These data indicate that DPN was more prevalent among patients with liver fibrosis and steatosis and that fibrosis was an independent predictor of DPN.

Disclosure: Shanghai Haishen Medical Electronic Instrument Co and Wuxi Hisky Medical Technologies Co supplied equipment used in the study. Please see the original reference for a full list of disclosures.


Huang J, Li R, Liu N, et al. Liver fibrosis is independently associated with diabetic peripheral neuropathy in type 2 diabetes mellitus. J Diabetes Investig. Published online May 4, 2021. doi:10.1111/jdi.13562