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Non-alcoholic fatty liver disease (NAFLD) has been related with an increased risk of cardiovascular disease (CVD). In order to explore the impact of diabetes mellitus (DM) as cardiovascular risk factor, this meta-analysis quantitatively assessed the association of NAFLD and CVD in diabetic patients.
PPubMed, Embase and the Cochrane Library database was analyzed until the end of March 2017. Original studies analyzing the association between NAFLD and cardiovascular risk factors in the diabetic population were included. The available data related to outcome was extracted for the effect estimate using a random-effects model. The quality of the included studies was assessed by the Newcastle-Ottawa Quality Assessment Scale (NOS).
Of the 770 initially identified studies, eleven studies involving 8346 subjects were finally included. The NOS scores suggested the included studies were of high quality. The pooled effects estimate revealed that diabetic patients with NAFLD exhibited a 2 times increased risk for CVD compared to patients without NAFLD [odds ratio (OR) = 2.20, 95% confidence interval (CI): = 1.67–2.90]. Subgroup analysis also yielded a remarkable increased risk with OR [CI] values of 2.28 [1.61–3.23] and 1.90 [1.48–2.45] in cross-sectional and cohort studies, respectively.
This is the first meta-analysis investigating the relationship between NAFLD and CVD independent of the impact of DM. Our findings suggested that NAFLD increases the risk of CVD in populations with comparable DM profiles. Diabetic patients diagnosed with NAFLD might benefit from a more early cardiovascular risk assessment thereby reducing CVD morbidity and mortality.