Prevalence of diabetic neuropathy in nonalcoholic fatty liver disease (NAFLD) patients: A systematic review and meta-analysis

Nonalcoholic fatty liver disease (NAFLD) refers to the uncontrolled accumulation of triglyceride (TG) in the liver when the person has no other liver disease etiologies. Among all causes of neuropathy, diabetic neuropathy is the most common one worldwide, and it causes notable morbidity and increases mortality. The prevalence of diabetic neuropathy and NAFLD has been demonstrated in few studies. This study aims to summarize existing data estimating peripheral diabetic neuropathy prevalence among sonographically detected NAFLD patients. We searched PubMed, Scopus, Web of Science, and Google scholar for articles in the English language up until October 2021 for the clinical trials of diabetic neuropathy in NAFLD patients and used the articles for a systematic review and meta -analysis. Seven studies (6,918 patients with type 2 diabetes mellitus (T2DM)) were involved. The prevalence of diabetic neuropathy among T2DM patients with ultrasound (US) detected-NAFLD was 0.48 (95% CI= 0.31-0.65, I 2 = 99.01%), however it was not significantly different from patients without NAFLD (OR=1.02, 95% CI= 0.89-1.17. p =0.748, I 2 =81.6%). The prevalence of diabetic neuropathy among T2DM patients with NAFLD is not significantly different from patients without NAFLD.