Type 1 diabetes is not associated with an increased prevalence of hepatic steatosis.

AIM: Non-alcoholic fatty liver disease (NAFLD) is commonly associated with Type 2 diabetes. Recently, it has been suggested that NAFLD is also frequently associated with Type 1 diabetes and diabetic complications. In this study, we set out to determine whether Type 1 diabetes was associated with liver fat content measured using magnetic resonance imaging. METHODS: One hundred and twenty-eight patients with Type 1 diabetes, 264 patients with Type 2 diabetes and 67 participants without diabetes were included in this study. Hepatic steatosis was defined as a liver fat content > 5.5%. RESULTS: People with Type 1 diabetes and controls were similar for age and BMI. Liver fat content was significantly higher in patients with Type 2 diabetes than in patients with Type 1 diabetes and controls. In the control group, nine people (13.4%) had steatosis compared with six (4.7%) patients with Type 1 diabetes (P = 0.04). Among patients with Type 2 diabetes group, 166 (62.8%) had steatosis. In multivariate analysis that included patients with Type 1 diabetes and participants without diabetes, steatosis was associated only with BMI, whereas age, sex, statin therapy and Type 1 diabetes were not. In patients with Type 1 diabetes, there was no correlation between liver fat content and estimated glomerular filtration rate or carotid intima media thickness. CONCLUSIONS: Our data showed that Type 1 diabetes was not associated with an increased prevalence of steatosis. Moreover, our study provided no specific arguments concerning a link between liver fat content and diabetic complications in patients with Type 1 diabetes.

Increased erythrocytes n-3 and n-6 polyunsaturated fatty acids is significantly associated with a lower prevalence of steatosis in patients with type 2 diabetes.

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is commonly associated with obesity, metabolic syndrome and type 2 diabetes. Although dietary fat contributes substantially to the accumulation of liver fat, the role of individual fatty acids in this accumulation is unclear. OBJECTIVE: In this study, we set out to determine whether liver fat content (LFC), was associated with red blood cell fatty acid (RBC-FA) composition in people with type 2 diabetes. DESIGN, SETTINGS, AND PARTICIPANTS: One hundred and sixty-two type 2 diabetic patients were included in this study. LFC was measured using (1)H-MR Spectroscopy. RBC-FA composition was measured by gas chromatography. RESULTS: One hundred and nine (67.2%) patients had steatosis. Patients with steatosis had a higher BMI (p = 0.0005), and higher plasma triglyceride levels (p = 0.009) than did patients without steatosis. We report a significant association between palmitic acid (16:0), palmitoleic acid (16:1n-7) concentrations and ratio of monounsaturated to saturated fatty acid (palmitoleic acid to palmitic acid) and higher liver fat content. Total polyunsaturated fatty acid (PUFA), homo-gamma-linolenic acid (20:3n-6), docosahexaenoic acid (22:6n-3), and arachidonic acid (20:4 n-6) were associated with lower LFC. CONCLUSIONS: Our data showed that an increased erythrocytes long-chain n-3 and n-6 fatty acids was associated with a lower prevalence of steatosis in patients with type 2 diabetes. These results suggest that n-3 and n-6 fatty acids supplementation could be a promising treatment for NAFLD in patients with type 2 diabetes.

The "planned" families of Tunisia.

PIP: 30 years ago Tunisia achieved independence, and 20 years ago it adopted a family planning policy designed to bring about a balance between demographic and economic growth. Birth control and family planning continue to be a major concern, and services now are provided in over 800 public sector centers -- dispensaries, hospitals, family planning clinics, and mobile teams. 4 out of 10 married women use some form of contraception, and some 30,000 abortions are performed per year by services of the National Office for Family Planning and Population. 2/3 of Tunisians believe that religion has a favorable view of birth control, but there are other sources of resistance to birth control -- sources related to a woman's level of education, her status, and socioeconomic level. The average number of children/woman decreases according to her level of education, from 6.9 among illiterate women to 2.6 among women with a university education. The proportion of illiterate women in Tunisia is close to 50%; the level is as high as 75% among women over age 30. These figures provide the explanation as to why the decline in the birthrate has been so slow. Another major determinant of reproduction rates among Tunisian women is access to employment. Women with jobs have an average of 2 children in contract to women without jobs who normally have more than 4 children. A marked decline occurred in the birthrate between 1966-76, and about 2/3 of Tunisian women now subscribe to the modern family model, i.e., a smaller family oriented toward consumption and comfort. Yet, despite improvements, under the best-case scenario the reproduction rate would be 3.8 children/family at 2000, and a rate of 2.9 would not be achieved until 2020, which is still higher than the rate necessary for simple population replacement -- 2.1. This downward trend would be realized under the combined effects of socioeconomic and cultural changes, i.e., better education, urbanization, declining infant mortality, the gradual integration of the rural community into the national economy, and the popularization of birth control methods.^ieng