Abstract
Introduction: Non-alcoholic fatty liver disease is more prevalent among type 2 diabetes(T2D). Apart from liver related morbidity and mortality, fatty liver is associated with increased risk for cardiovascular disease. Severity of hepatic brosis correlates with poor outcome. Early diagnosis and treatment will improve the quality of life. Transient elastography (TE) is a validated tool for assessment of severity of brosis. We estimate the proportion of patients with signicant brosis and its determinants using TE in south india. Methods: Hospital based prospective cross sectional study was conducted among type 2 diabetes patients with ultrasound abdomen reported as fatty liver over the study period of one year. Exclusion criteria was applied to rene the study population to asymptomatic non alcoholic fatty liver disease patients. TE examination was done and signicant hepatic brosis (≥ F2 = 7.1 to 8.7kpa) was correlated with various blood parameters and anthropometrics. Results: 140 patients were selected from 781 type 2 diabetes population. Proportion of signicant brosis (≥ F2) was 47.1 percent. All patients except one were either obese 59(89.4%) or overweight 6(9.1%) in the subgroup of signicant brosis. T2D patients with uncontrolled HbA1c levels had more signicant brosis (p = 0.02) than controlled patients. Liver enzymes (AST/ALT) and lipid prole measurements do not correlate with signicant brosis. Ultrasound abdomen imaging fails to detect signicant brosis in two third of cases (p=0.002). Conclusion: Nearly half of type 2 diabetes with NAFLD in south India had signicant hepatic brosis. Higher BMI (> 30) and poor glycemic control were key determinants of signicant hepatic brosis. This subset of T2D patients warrant TE screening study
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