Non-Alcoholic Fatty Liver Disease among Type-2 Diabetes Mellitus Patients in Abha City, South Western Saudi Arabia.

Abdullah Alsabaani,Nabil Awadalla,Ahmed Mahfouz,Mustafa Musa,Suliman Al Humayed

doi:10.3390/ijerph15112521

Abstract

The objective of this study was to determine the prevalence and the factors associated with non-alcoholic fatty liver disease (NAFLD) among type-2 diabetes mellitus (T2DM) patients in Abha City, Southwestern Saudi Arabia. Using a cross-sectional study design, a representative sample of 245 T2DM patients were recruited from all primary healthcare centers in Abha city. A detailed medical history as well as laboratory investigations were done. NAFLD was diagnosed using abdominal ultrasound examination. The overall prevalence of NAFLD was 72.8% (95% CI: 66.6%–78.1%). In a multivariable regression analysis, the risk of NAFLD was significantly higher among overweight T2DM patients (aOR = 6.112, 95% CI: 1.529–4.432), Obese (aOR = 10.455, 95% CI: 2.645–41.326), with high ALT of more than 12 IU/L (aOR = 2.335, 95% CI: 1.096–5.062), moderate diet-compliant patients (aOR = 2.413, 95% CI: 1.003–5.805) and poor diet-compliant patients (aOR = 6.562, 95% CI: 2.056–20.967). On the other hand, high HDL (high density cholesterol) (in mg/dL) was a protective factor for NAFLD (aOR = 0.044, 95% CI: 0.005–0.365). It was concluded that NAFLD is a common association of T2DM. Increasing BMI (Body mass index), lower HDL level, and poor dietary control are significant factors associated with NAFLD among T2DM patients. Health education to improve dietary control and avoid excessive weight gain, testing for NAFLD among diabetic patients, especially those with abnormal BMI and HDL, are recommended for early detection and to ensure optimal levels of HDL.

Highlights

Non-alcoholic fatty liver disease (NAFLD), defined as the presence of hepatic steatosis in the absence of secondary causes, is emerging as a public health issue worldwide, with a global pooled prevalence, by imaging, of 25.24% among the general population [1]
The present study showed that non-alcoholic fatty liver disease (NAFLD) was found among 178 type-2 diabetes mellitus (T2DM) patients, giving a prevalence of 72.7%
NAFLD: Non-alcoholic fatty liver disease; T2DM: Type-2 diabetes Mellitus; HbA1c: glycosylated hemoglobin; high density cholesterol (HDL): High Density Lipoprotein; low density cholesterol (LDL): Low density lipoprotein; ALT: alanine aminotransferase; AST: aspartate aminotransferase; Crude odds ratios (cOR): crude Odds Ratio; Adjusted odds ratios (aOR): adjusted Odds Ratio; 95% CI: 95% Confidence Interval; Normal *

Summary

Introduction

Non-alcoholic fatty liver disease (NAFLD), defined as the presence of hepatic steatosis in the absence of secondary causes, is emerging as a public health issue worldwide, with a global pooled prevalence, by imaging, of 25.24% among the general population [1]. NAFLD is the most common chronic liver disease in the industrialized countries; it is the major cause of cryptogenic cirrhosis. NAFLD is a disease that can occur in all sexes, ages, and ethnic groups. The major risk factors of NAFLD are obesity, hyperlipidemia, diabetes mellitus, and metabolic syndrome Res. Public Health 2018, 15, 2521; doi:10.3390/ijerph15112521 www.mdpi.com/journal/ijerph

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