Non-alcoholic fatty liver disease in patients with type 2 diabetes in Greenland: a register-based cross-sectional study

• Published in: International Journal of Circumpolar Health
• Main Authors: Abdullah Ghassan Muhammad, Frederik Orm Hansen, Rasmus Hvidbjerg Gantzel, Karsten Fleischer Rex, Gerda Elisabeth Villadsen, Henning Grønbæk, Michael Lynge Pedersen
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2022
• Subjects: Liver steatosis; liver fibrosis; type-2 diabetes mellitus; Greenland; Greenland Inuit; Danes; Arctic medicine. Tropical medicine; RC955-962; Arctic; Circumpolar Health; greenlander*; International Journal of Circumpolar Health; inuit
• Online Access: https://doi.org/10.1080/22423982.2022.2065755; https://doaj.org/article/8a11f535f4f54ba3984ce575eed8b5a6

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide due to its close association to the metabolic syndrome of type 2 diabetes mellitus (T2DM), obesity and insulin resistance. However, the prevalence and severity of NAFLD in Greenland remain unexplored. We aimed to estimate the prevalence of liver steatosis and fibrosis among Greenlanders and Danes with T2DM living in Greenland using biochemical surrogate markers. We included 1409 Greenlanders and 182 Danes with T2DM in this register-based cross-sectional study. Greenlanders had higher BMI and plasma lipid levels and lower HbA1c levels compared with Danes (p<0.05). Their median alanine aminotransferase (ALAT) levels were similar. However, more Greenlanders had elevated ALAT levels (20.5% vs. 11.5%, p<0.05). Greenlanders had lower FIB-4 scores than Danes, 0.91 (IQR: 0.66–1.27) vs. 0.97 (IQR: 0.78–1.34), without difference in FIB-4 score categories (p=0.27). The prevalence of advanced fibrosis was low in both populations (1.7–2.6%). In conclusion, Greenlanders with T2DM had better glycaemic control despite higher BMI and plasma lipids. A larger proportion of Greenlanders had elevated plasma ALAT levels, while FIB-4 scores were lower than Danes. These findings suggest that Greenlanders with T2DM may be less likely to develop liver complications than Danes with T2DM in Greenland.