Abstract
Introduction: Non-alcoholic fatty liver disease (NAFLD) is one of the most prominent causes of chronic liver disease. It is known that dyslipidemia in NAFLD patients may have more severe atherogenic potential with high triglyceride and low density lipoprotein (LDL) as well as less high density lipoprotein (HDL) level.
 Objective: To determine the atherogenic dyslipidemia and associated factors among patients with NAFLD, Visiting Tertiary Care Center
 Methodology: Prospective cross-sectional study was conducted at Dhulikhel Hospital-Kathmandu University Hospital (DH-KUH) from January, 2016 to December, 2016. All the patients (n= 973) diagnosed to have fatty liver during this study period were initially enrolled in this study. Patients were further asked to fill up the questioner. Out of total 973 cases, 169 patients were identified as NAFLD. Fasting blood sample and anthropometric measurements (BMI, WHR) were taken. After adjusting exclusion criteria, refusal to participate and dropout from the study, 101 patients and 92 apparently healthy age sex matched control group was selected for the study. Blood sugar level and lipid profile were analyzed to assess the risk of athrogenicity among the NAFLD.
 Result: High total cholesterol was found in 64.4 %, High LDL was found in 20.8 %, Low HDL is present in 72.2% and high triglyceride is present in 65.8 % patients with NAFLD. Non-HDL cholesterol was significantly higher in NAFLD compared to control group (116.75 ± 34.38 vs. 137.63 ± 39.76, p=0.00). Similarly, calculated cardiac risk ratio (TC/HDL) was significant higher (4.15 ± 1.18 vs. 5.25 ± 1.78, p=0.00) whereas atherogenic index of plasma (AIP) was higher (0.30 ± 0.13 vs. 0.33 ± 0.19, p=0.37).
 Conclusion: NAFLD is significantly associated with atherogenic dyslipidemia. Calculated cardiac risk and AIP is higher in patients with NAFLD. Therefore it may be helpful to assess dyslipidemia among the patients with NAFLD to prevent cardiovascular events.
Highlights
Non-alcoholic fa y liver disease (NAFLD) is one of the most prominent cause of chronic liver disease affec ng nearly 30% of popula on.[1,2] This is associated with risk for development of cirrhosis and liver cancer, as it is es mated that NAFLD will be the leading cause of liver transplanta on by 2030.3 The development of NAFLD is strongly associated with metabolic syndrome (MetS) as reflected by the fact that approximately 90 % of pa ents with NAFLD have more than one feature of MetS and about 33% have three or more criteria like, abdominal obesity, elevated triglycerides, reduced high density lipoprotein (HDL)-C level, hypertension and impaired fas ng glucose.[4]
NAFLD is significantly associated with atherogenic dyslipidemia
Calculated cardiac risk and atherogenic index of plasma (AIP) is higher in pa ents with NAFLD
Summary
Non-alcoholic fa y liver disease (NAFLD) is one of the most prominent cause of chronic liver disease affec ng nearly 30% of popula on.[1,2] This is associated with risk for development of cirrhosis and liver cancer, as it is es mated that NAFLD will be the leading cause of liver transplanta on by 2030.3 The development of NAFLD is strongly associated with metabolic syndrome (MetS) as reflected by the fact that approximately 90 % of pa ents with NAFLD have more than one feature of MetS and about 33% have three or more criteria like, abdominal obesity, elevated triglycerides, reduced HDL-C level, hypertension and impaired fas ng glucose.[4]. Study shows that prevalence of NAFLD in Nepal is increasing in hospital based studies,[7] but Na onal prevalence of NAFLD of Nepal is not well documented. This alarming condi on rises the possibili es of higher prevalence of NAFLD associated CVD among Nepalese popula on. In general NAFLD is an asymptoma c and progresses as a silent disease which can be iden fied a er basic rou ne health examina ons having some biochemical changes in liver enzymes without any other specific causes like, alcohol consump on, virus infec on, effects of drugs and autoimmune diseases.[8] Most NAFLD pa ents have no signs or symptoms of liver disease at the me of diagnosis. The diagnosis of NAFLD needs confirma on of hepa c steatosis based on either imaging studies or liver biopsy, together with the clinical examina ons. 10
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