Prevalence and Clinical Characteristics of Nonalcoholic Liver Disease in Type 2 Diabetes Mellitus Patients: A Cross-sectional Study

Abstract

Introduction: A refined diagnostic and classification strategy incorporating phenotypic characteristics of patients with Type 2 Diabetes Mellitus (T2DM) along with their blood glucose profile, lipid levels and evidence of Nonalcoholic Fatty Liver Disease (NAFLD) will help in identifying high risk population. Aim: To determine the prevalence and assess the clinical characteristics of NAFLD in T2DM patients from August 2016 to February 2017. Materials and Methods: This cross-sectional analysis was conducted on 100 T2DM patients with no history of alcohol intake, at the time of their screening. Physical examination and anthropometric measurements such as Body Mass Index (BMI) and Waist to Hip Ratio (WHR) were calculated. Fasting Blood Glucose (FBG), Post-Prandial Blood Glucose (PPBG), glycated haemoglobin (HbA1c), serum bilirubin, liver enzymes, lipid profile and ultrasound of the abdomen to diagnose NAFLD were done. Statistical analysis was carried out using student’s t-test and Statistical Package for the Social Sciences (SPSS) Version 19. Results: The prevalence of NAFLD in T2DM patients was 52%. The mean age was 52.27±1.82 years, with 40% males in the study cohort. There was a significant statistical correlation between the higher BMI (p<0.001), higher WHR (p=0.046), prevalence of upper body obesity (p<0.001) and the presence of NAFLD. The glycaemic control was poorer in patients with NAFLD with higher FBG (p=0.0027), PPBG (p=0.0027) and HbA1c p<0.001) than the non-NAFLD group. The serum cholesterol, triglycerides, Serum Glutamic Pyruvic Transaminase (SGPT), Serum Glutamic Oxaloacetic Transaminase (SGOT) were significantly higher in the NAFLD group. Duration of diabetes was not significantly different among the groups. Conclusion: The incidence of NAFLD is common in T2DM patients with poor glycaemic control, dyslipidaemia, and obesity being associated factors. Duration of diabetes is not a significant predictor of NAFLD.