Diagnostic Value of Acyl-Ghrelin in Type 2 Diabetic Patients with Non-alcoholic Fatty Liver Disease

Abstract

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has become the leading cause of chronic liver disease worldwide. Type 2 diabetes (T2D) is described as one of the most significant risk factor for developing NAFLD, non-alcoholic steatohepatitis, and advanced cirrhosis. Liver biopsy cannot be used routinely to diagnose NAFLD. Therefore, it is critically urgent to develop a simple non-invasive test. AIM: This study examined fasting Acyl-Ghrelin (AG) as a non-invasive biomarker to accurately diagnose NAFLD in diabetic patients. PATIENTS AND METHODS: Sixty-one patients with T2D were divided into a test group with NAFLD, and a control group without NAFLD. Secondary causes of fatty liver, chronic viral hepatitis, and drug-induced liver damage were excluded from the study. Anthropometric measurements, lipid profile, fasting blood sugar (FBS), liver enzyme activities, and fasting AG levels were collected. Data management and analysis were performed using statistical package for social sciences version 20. RESULTS: Fasting AG level (pg/ml) in the test group (56.1 ± 10.7) was increased, but not statically significant compared with the control group (37.8 ± 9.3), p > 0.05. However, significant metabolic changes were observed in body weight, waist circumference, FBS, alanine transaminase, and aspartate transaminase between test and control groups. The mean values in the test group are 93.2 ± 14.5, 115.4 ± 7.6, 144.2 ± 25.9, 21.1 ± 5.7, and 32.3 ± 2.1. While the mean values are 87.7 ± 7.3, 95 ± 3.8, 123.7 ± 20.7, 18.6 ± 5, and 20 ± 7, respectively, in the control group. CONCLUSIONS: While elevated AG levels alone were not significant, elevated AG levels plus other parameters of liver damage and obesity were associated with the diagnosis of NAFLD. However, more studies are needed to consider elevated AG as a diagnostic marker in NAFLD patients with T2D.