The Risk Factors Of Non-Alcoholic Fatty Liver Disease Prevalence In Obesity With Or Without Diabetes Mellitus

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Background. The main cause of non-alcoholic fatty liver disease (NAFLD) is insulin resistance and the one of the most common risk factors for insulin resistance is obesity. The abnormality of lipid metabolism can be seen in NAFLD such as: High level of free fatty acid (FFA) in plasma, formation of reactive oxygen species and high level of lipid peroxidation (malondialdehyde (MDA) and trans-4-hydroxy-2-nonenal).Objective. The aim of the study is to find the risk factors of NAFLD prevalence in obesity with or without diabetes mellitus.Methods. Case control study. The population was taken from general check up patients in Internal Medicine Department, Dr. Sardjito General Hospital Yogyakarta Indonesia, March 2007 until August 2008. The case group is obesity who suffered diabetes mellitus and the control group is obesity without diabetes mellitus. The Subjects who fulfilled inclusion and exclusion criteria are enrolled in this study. Diagnosis of NAFLD is defined by Liver Ultrasound (Bright Liver appearance). AST, ALT, GGT, cholesterol, triglyceride, fasting glucose, 2 hour post-prandial glucose, insulin, Apo-B, FFA, MDA and adiponectin were examined. Data analyzed by computer using t-test for different of mean, Anova and linear regression test for significant factors (CI 95% and p < 0.05), and odd ratio for risk factors. Results. The fourty six obese patients (case 23 pts, control 23 pts) are matched to age and sex. Significant difference are shown in triglyceride, FFA and adiponectin level (p: 0.013; p: <0.001; and p: 0,045). There are no significant difference in insulin resistance, cholesterol, MDA and Apo-B level. By linear regression test, triglyceride, FFA and adiponectin level are predicted as significant factor (p<0.05) with odd ratio 1.64, 12.4, and 0.9.Conclusion. Increasing of triglyceride, FFA and adiponectin level in obesity with diabetic have risk of NAFLD prevalence with odd ratio 1.64 time (triglyceride), 12.4 (FFA) and 0.9 (adiponectin).