Abstract
Objective:Non-Alcoholic Fatty Liver Disease (NAFLD) is emerging as a major public health problem globally especially in patients with Type-2 Diabetes mellitus (T2DM). This study aimed to assess the frequency of NAFLD in patients with T2DM and to study its associated risk factors.Methods:This descriptive study was conducted from April 2020 to October 2020 at the Hayatabad Medical Complex, Peshawar. Adult patients with T2DM were included in the study and underwent abdominal ultrasound for the identification of NAFLD. All the relevant clinical and biochemical characteristics were measured.Results:Out of 384 participants, 236 patients (61.5%) had NAFLD on ultrasound. Patients with NAFLD had higher mean BMI, higher HbA1c, increased waist circumference, raised ALT, higher triglyceride, and low HDL. Logistic regression analysis revealed a statistically significant association with central obesity (OR = 5.448, 95% CI = 1.416-20.959, p = 0.014), higher BMI (OR = 4.435, 95% CI = 2.127-9.246, p < 0.0001), higher HbA1c [> 11%] (OR = 3.602, 95% CI = 1.438-9.019, p = 0.006), and elevated ALT (OR = 3.211, 95% CI = 1.509-6.835, p = 0.002). The highest odds for NAFLD were found for hypertriglyceridemia (OR = 11.624, 95% CI = 5.405-24.998, p < 0.0001) and low HDL (OR = 11.543, 95% CI = 2.590-51.439, p = 0.001), respectively.Conclusions:High frequency of NAFLD along with its associated clinical and laboratory risk factors were revealed. This underpins the significance of screening T2DM patients for NAFLD and assessment for and modification of its associated risk factors in routine clinical practice.
Highlights
Non-alcoholic fatty liver disease (NAFLD) comprises of a spectrum of liver diseases, ranging from fatty liver to non-alcoholic steatohepatitis (NASH) which is accompanied by inflammation.[1]
The progressing epidemic of obesity and Type-2 Diabetes mellitus (T2DM) is accompanied by the rising incidence of NAFLD, the factors implicated for this raised prevalence of NAFLD in diabetics is only poorly studied.[5]
The baseline demographic and laboratory characteristics along with the comparison of clinical and laboratory findings between the two groups of patients are presented in Table-I and Table-II, respectively
Summary
Non-alcoholic fatty liver disease (NAFLD) comprises of a spectrum of liver diseases, ranging from fatty liver to non-alcoholic steatohepatitis (NASH) which is accompanied by inflammation.[1]. Global prevalence of NAFLD in the general public is around 15-30%, the prevalence amongst patients with obesity or T2DM is 7080%.5. This supports a bidirectional relationship between T2DM and NAFLD, suggesting that these metabolic disorders share a common pathogenic mechanism.[6] the concomitant presence of T2DM and NAFLD aggravates insulin resistance, favors the promotion of dyslipidemia and makes optimal glycemic control difficult to achieve, thereby developing major adverse cardiovascular events.[7] Transabdominal ultrasound scan (US) is a widely used diagnostic modality for NAFLD due its free availability, high sensitivity, low cost and non-invasive nature compared to the gold standard histological assessment which is limited in use because of invasive nature and associated complications. There is a rising tendency of these factors among Asian population who are genetically more susceptible to the presence of insulin resistance due to the difference in the amount and distribution of body fat from Caucasians.[8]
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