The liver plays a vital role in the body, including storing fat and sugar. Fatty liver occurs when the liver stores excessive fat. Type 2 diabetes and fatty liver are part of the metabolic syndrome and share several risk factors for developing cardiovascular disease.
EPSOMiP
The research project EPSOMIP (Prevalence and severity of fatty liver disease in primary care) brings together a multidisciplinary team of researchers with a shared interest in exploring the link between fatty liver, epicardial fat, and cardiovascular disease in type 2 diabetes.
Study Design
EPSOMiP (ClinicalTrials.gov identifier: NCT03864510) is a prospective study aiming to map the prevalence of non-alcoholic fatty liver disease (NAFLD) among patients with diabetes in primary care. The goal is to include 400 patients with type 2 diabetes. The study is being conducted in Norrköping and Linköping, with patient recruitment ongoing at the health centres Ekholmen, Kärna, Åby, and Cityhälsan Söder. After providing informed consent, participants are invited to a visit at the gastroenterology clinic in Linköping or the medical clinic in Norrköping. Routine blood tests are performed to exclude other liver diseases and confirm type 2 diabetes. All patients then undergo a clinical examination, including a detailed review of medical history, current and past medication, and relevant lifestyle factors (exercise and alcohol consumption). During the visit, an elastography measurement (Fibroscan®) is performed.
Participants also complete validated questionnaires, including those on physical activity. A six-minute walk test is conducted, where participants are asked to walk as far as possible along a 50-metre stretch within six minutes. Each participant is also equipped with an accelerometer to measure physical activity at home over one week. At a later stage, patients are invited to CMIV in Linköping or the Radiology Department in Norrköping for an MRI scan to assess body composition, muscle atrophy, and fat and connective tissue in the liver.
EPSOMIP-Sleep
Participants in EPSOMiP are also offered the opportunity to take part in the sub-study EPSOMiP-Sleep, which involves home-based diagnostics for sleep apnoea. Sleep apnoea refers to short, repeated pauses in breathing during the night and is associated with blood pressure and blood sugar control. In EPSOMiP-Sleep, participants are equipped with devices to measure potential breathing interruptions and oxygen levels during sleep. Sleep-related questionnaires are also completed to assess sleep quality and the risk of sleep apnoea.
