A study of prevalence of non-alcoholic fatty liver disease in type 2 Diabetes Mellitus

Kuldeep Chandel, Sandeep Kumar, Waseem Farooqui, Mahak Lamba

Abstract


Nonalcoholic fatty liver disease (NAFLD) is one of the common causes of chronic liver disease worldwide and is an emerging important cause of liver disease in India. In the general Indian population, the prevalence of NAFLD is approximately 9- 30% but much higher estimates are reported in obese and patients with type 2 diabetes mellitus. Total of 185 diabetic and 105 non-diabetic patients were randomly selected from diabetic and medicine OPD. After taking informed consent, all patients undergone history, examination and routine laboratory investigations, LFT, lipid profile, HbA1c, serum ferritin, C-reactive protein and USG. The results of cases and control were compared with unpaired t -test and p value <.05 was considered significant. The study group (n=185) was divided into a NAFLD group (n=102) and a non-NAFLD group (n=83) and non-diabetic control (n=105). The prevalence of NAFLD in DM was 55.68% and in non-diabetic was 20%. The NAFLD was significantly associated with high BMI, waist circumference and waist hip ratio, higher HbA1c, higher triglyceride levels, hypercholesterolemia, low HDL levels. Serum CRP level (p<0.00001) and serum ferritin level (p<0.0001) were significantly high in NAFLD patients with DM-2. This study showed that patients with central obesity, Poor Glycemic control and dyslipidemia are at increased risk of developing NAFLD. Serum ferritin and Serum CRP could be good noninvasive marker for screening of NAFLD in asymptomatic patients.

 

Keywords: Nonalcoholic fatty liver disease, Ferritin, Diabetes mellitus

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References


Pradeepa R, Deepa R, Mohan V. Epidemiology of diabetes in India--current perspective and future projections. J Indian Med Assoc2002 Mar;100(3):144-8.

Angulo P, Lindor KD. Non-alcoholic fatty liver disease. J GastroenterolHepatol2002; 17 (Suppl):S186–S190.

Hsiao PJ, Kuo KK, Shin SJ. Significant correlations between severe fatty liver and risk factors for metabolic syndrome. J Gastroenterol Hepatol2007;22:2118–2123.

Arun J, Clements RH, Lazenby AJ, Leeth RR, Abrams GA. The prevalence of nonalcoholic steatohepatitis is greater in morbidly obese men compared to women. Obes Surg 2006 Oct;16(10):1351-8.

Kalra S, Vithalani M, Gulati G, Kulkarni CM, Kadam Y, Pallivathukkal J, et al. Study of prevalence of non-alcoholic fatty liver disease(NAFLD) in type 2 diabetes patients in India (SPRINT).J Assoc Physicians India 2013 Jul;61(7):448-53.

V Viswanathan, Mahesh Kadiri, Srikanth Medimpudi, Satyavani Kumpatla. Association of NAFLD with diabetic micro and macrovascular complications in South Indian diabetic subjects. International J of Diabetes in Developing Countries 2010;30(4):208.

Bedogni G, Miglioli L, Masutti F. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos Nutrition and Liver Study. Hepatology 2005;42:44–52.

Aparna G, Prabhakar K, Jayaram N, Raghavendra Prasad BN. Prevalence of autoimmune markers in young adults with diabetes. Diabetes - Journal of the Association of Physicians of India Feb2014;62.

Salmela PI, Sotaneimi EA, Niemi M. Liver Function test in diabetic patients. Diabetic care 1984;7:248.

AK Agarwal, V Jain, S Singla, BP Baruah, V Arya. Prevalence of non-alcoholic fatty liver disease and its correlation with coronary risk factors in patients with type 2diabetes. JAPI 2011 Jun;59:351-4.

MV Jali, Sanjay Kambar, Sujata M. Jali, Murigendra B. Hiremath. Prevalence of non- alcoholic fatty liver disease among type-2 diabetes mellitus patients – A cross-sectional hospital based study. Al Ameen J Med Sci 2015;8(1):50-54.

Prashanth M, Ganesh HK, Vima MV, John M, Bandgar T, Joshi SR, et al. Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus. Assoc Physicians India 2009 Mar;57:205-209.

KCHu, HY Wang, SC Liu, CC Liu. Nonalcoholic fatty liver disease: Updates in noninvasive diagnosis and correlation with cardiovascular disease - World Journal of Gastroenterol 2014 Jun 28;20(24):7718-29.

Kowdley KV, Belt P, Wilson LA, Yeh MM, Neuschwander-Tetri BA, Chalasani N, et al. Serum ferritin is an independent predictor of histological severity and advanced fibrosis in patients with non-alcoholic fatty liver disease. Hepatology2012 Jan;55(1):77-85.

Hsiao TJ, Chen JC, Wang JD. Insulin resistance and ferritin as major determinants of non-alcoholic fatty liver disease in apparently healthy obese patients. Int J ObesRelatMetabDisord2004 Jan;28(1):167-72.