Abstract

Objectives: To predict the role of different clinical and biochemical parameters in identifying nonalcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes mellitus (T2DM) in Abha city, southwestern Saudi Arabia. Methods: A stratified random sample was selected. A detailed clinical and biochemical examinations were performed. Using portable abdominal ultrasound examination, NAFLD was identified. The study used receiver operating characteristic (ROC) analysis. Results: The study covered 237 T2DM patients. NAFLD was detected among 174 patients. Area under the curve (AUC) calculations showed that the ability of age, duration of DM in years, and body mass index to predict NAFLD was poor (AUC < 0.6). Similarly, biochemical factors like HbA1c%, AST, cholesterol, triglycerides, HDL, LDL, and VLDL were poor in discriminating between those with and without NAFLD among T2DM. On the other hand, the ability of ALT to predict NAFLD among T2DM was good (AUC = 0.701, 95% CI: 0.637–0.761). The analysis identified the optimal cutoff point of ALT to be ≤22.1 nmol/L. The corresponding sensitivity was 60.7% (95% CI: 53.0–68.0) and specificity was 62.5% (95% CI: 49.5–74.3). Conclusions: Early identification of NAFLD among T2DM is important. A threshold cutoff value of 22.1 nmol/L of ALT has been identified to predict NAFLD. They should be referred for ultrasound examination for NAFLD.

Highlights

  • Nonalcoholic fatty liver disease (NAFLD) is described as hepatic steatosis not produced by extra consumption of alcohol, viruses such as hepatitis B or C, autoimmune hepatitis, using of hepatotoxic drugs or other compounds, or rare genetic forms [1]

  • It includes a variety of illnesses from simple steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis

  • The relationship between NAFLD and type 2 diabetes mellitus (T2DM) has been well proven, which could be described by the insulin challenge and compensatory hyperinsulinemia advancing to faulty lipid metabolism and hepatic triglyceride (TG) increase in NAFLD or to b-cell malfunction in T2DM [4]

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Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is described as hepatic steatosis not produced by extra consumption of alcohol, viruses such as hepatitis B or C, autoimmune hepatitis, using of hepatotoxic drugs or other compounds, or rare genetic forms [1]. It includes a variety of illnesses from simple steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis. Diagnostics 2020, 10, 809 identification, 65–87% of patients with type 2 diabetes (T2DM) have NAFLD [3]. Studies revealed that NAFLD–T2DM correlation is in both directions [5]

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