Association between non‐alcoholic fatty liver disease and peripheral artery disease in patients with type 2 diabetes

Abstract Background Non‐alcoholic fatty liver disease ( NAFLD ) is associated with the risk of coronary heart diseases; however, the relationship between NAFLD and peripheral artery disease ( PAD ) in patients with type 2 diabetes has not been investigated. Aim To investigate the association between NAFLD and PAD in patients with type 2 diabetes. Methods We carried out a cross‐sectional study on 2646 type 2 diabetes patients ≥ 40 years. All patients provided fasting blood samples and underwent a liver ultrasonography and ankle‐brachial index ( ABI ) test. PAD was defined as an ABI <0.9. Multiple logistic regression analyses were performed to investigate the odds ratio ( OR ) for PAD associated with NAFLD . Results Our analyses showed that patients with NAFLD had a significantly higher prevalence of PAD compared with those without NAFLD (12.8% vs 7.8%). NAFLD was associated with a 75% ( OR 1.75, 95% confidence interval ( CI ) 1.35–2.28) increased risk of PAD after adjustment for demographic factors. Addition of various metabolic risk factors as confounders attenuated the association ( OR 1.49, 95% CI 1.12–2.00). Further adjustment for C‐reactive protein led the association to be marginally significant ( OR 1.33, 95% CI 0.99–1.80). Analyses stratified by gender suggested the association was much stronger among women than among men. Conclusion Type 2 diabetes patients with NAFLD had a higher prevalence of PAD , and this association was partly, but not entirely, explained by metabolic risk factors and inflammation.