Association of Non-Alcoholic Fatty Liver Dis-ease and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: a Cross-Sectional Study

Background: Diabetic retinopathy is a common chronic complication of diabetes and one of the leading causes of acquired blindness in the world. There is growing evidence that traditional risk factors do not fully justify the onset and progression of diabetic retinopathy. Therefore, some other risk factors such as non-alcoholic fatty liver disease may be involved in the pathophysiology of diabetic retinopathy. This study aims to investigate the association of non-alcoholic fatty liver disease with diabetic retinopathy in a group of patients with type 2 diabetes mellitus. Materials and Methods: This cross-sectional study enrolled 1294 patients with type 2 diabetes mellitus. All participants were evaluated for retinopathy and non-alcoholic fatty liver disease. Systemic examination, eye examination, biochemical tests, and liver ultrasound were performed for all participants. Independent t-test was used to evaluate the differences between continuous variables and chi-square test was used for qualitative variables. Multiple logistic regression analysis was used to estimate the odds ratio of different components in the development of diabetic retinopathy. All analyses were performed in STATA software version 22. Results: Of the participants, 71.87% had non-alcoholic fatty liver disease, and 39.56% had retinopathy. Multivariate logistic regression analysis of risk factors showed that non-alcoholic fatty liver disease and male sex were independently associated with diabetic retinopathy. Conclusion: This study showed that non-alcoholic fatty liver disease is very common in patients with type 2 diabetes. In these patients, non-alcoholic fatty liver disease is a risk factor for diabetic retinopathy.