Central obesity but not generalised obesity (body mass index) predicts high prevalence of fatty liver (NAFLD), in recently detected untreated, IGT and type 2 diabetes Indian subjects (original) (raw)
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Journal of the Indian Medical Association, 2009
Recently detected 152 IGT and 158 type 2 diabetes patients aged between 30 and 69 years, never treated with any antidiabetic drug, lipid lowering agent, angiotension converting enzyme (ACE) inhibitor and/or angiotensin receptor blocker (ARB) were evaluated. One hundred and sixty asymptomatic, willing, healthy, normoglycaemic spouse or unrelated attendants accompanying the patients were also selected. History of significant alcohol intake or hepatotoxic drugs and positive serologic findings for hepatitis B and C viruses were excluded. The prevalence of fatty liver was 64% in type 2 DM, 52% in impaired glucose tolerance (IGT) and 20% in normal glucose tolerance (NGT) subjects. Subjects with fatty liver had significantly higher body mass index (BMI), waist, waist hip ratio, waist to height ratio, triglyceride, fasting insulin, insulin resistance (HOMA-IR), along with significantly lower HDL-C and quantitative insulin-sensitivity check index (QUICKI) compared to those without fatty live...
Indian Journal of Endocrinology and Metabolism, 2013
Background: Obesity is an important risk factor for non-alcoholic fatty liver disease (NAFLD); however, NAFLD does occur in lean subjects. This study was aimed to evaluate the magnitude, clinical, pathological, and metabolic profi les of NAFLD in normal body mass index (BMI) subjects (defi ned as lean NAFLD) in comparison to overweight or obese NAFLD and lean healthy control. Materials and Methods: 336 subjects (205 consecutive NAFLD, and 131 healthy controls) were studied. Results: Among 205 NAFLD patients, 27 (13.2%) were lean, while 141 (68.8%) and 37 (18%) patients were obese and overweight, respectively. The lean NAFLD compared to obese NAFLD had signifi cantly lesser degree of fasting hyperinsulinemia (P<0.001), homeostasis model assessment insulin resistance (HOMA-IR, P<0.001), and lower prevalence of diabetes mellitus (P=0.01) and metabolic syndrome (P<0.001). The profi les of serum lipids were similar between all 3 BMI categories, and 89% of lean NAFLD were dyslipidemic. Compared to obese subjects, patients with lean NAFLD had less hepatic necro-infl ammation (P=0.05) and fi brosis (P<0.001). However, the proportion of steatohepatitis and advanced fi brosis were similar between all BMI categories. The profi les of overweight NAFLD were similar to those of lean NAFLD, except for higher HOMA-IR, uric acids and male gender in overweight group. Despite being lean, the mean BMI of lean NAFLD were still higher than unselected lean healthy controls (P=0.02). Conclusions: Lean NAFLD patients have less severe disease, minor, or no insulin resistance, but are frequently dyslipidemic and have BMI higher than lean healthy control.
Diabetes Epidemiology and Management
Objective: This study aims to investigate the prevalence of nonalcoholic fatty liver disease (NAFLD), to determine the metabolic risk factors of this disease, and to predict nonalcoholic steatohepatitis (NASH) with liver fibrosis in women of different ages and body mass index (BMI). Methods: In 2010-2011, a cross-sectional survey was conducted among 9,360 women at the health checkup center of Zhongnan Hospital (Wuhan, China). The probability of NASH with liver fibrosis was predicted using BAAT (BMI, age, alanine aminotransferase, and triglycerides) score. Results: The prevalence of NAFLD increased from 5.3% to 18.8% in women younger than 45 years versus women aged 45 to 55 years and rose to 27.8% in women older than 55 years. In obese women, the prevalence of NAFLD was 48.4%. Women older than 45 years and obese women with NAFLD had more unfavorable metabolic risk factors. Multiple regression analyses showed that increased BMI and low aspartate aminotransferaseYtoYalanine aminotransferase ratio were closely related to NAFLD in women of different ages, whereas increasing BMI, BAAT score, age, high triglycerides, alanine aminotransferase, and low aspartate aminotransferaseYtoYalanine aminotransferase ratio were all closely related to NAFLD in obese women. The prevalence of NASH with a BAAT index of 3 or higher was 13.2% and 14.9% in women older than 55 years and obese women with NAFLD, respectively. Conclusions: Obese and postmenopausal women have a high prevalence of NAFLD and severe metabolic disorders. The prevalence of NASH seems to be considerably higher in obese and postmenopausal women with NAFLD.
The aim of the study was to investigate the incidence and factors linked with nonalcoholic fatty liver disease (NAFLD) among type-2 diabetes mellitus (T2DM) patients in Warangal, Telangana, India. It was an observational, cohort crosssectional study; a target sample of 100 T2DM patients was recruited from a single study site of Warangal. Detailed medical history was obtained and laboratory examinations and ultrasound imaging were carried out to evaluate the NAFLD. The overall incidence of NAFLD was 80%. The risk of NAFLD was significantly high in subjects with uncontrolled blood glucose levels, abnormal waist circumference, increased aspartate aminotransferase (AST), and elevated triglyceride levels (p < 0.05). In our study subjects, the consumption of alcohol is the predominant risk factor (Odds ratio: 6.652; 95% confident interval: 1.86-23.74 and p = 0.00*) significantly causing NAFLD among the study subjects. Grade-1 and 2 fatty livers are typically associated with elevated AST levels and a high incidence was observed in men.
Combined influence of nonalcoholic fatty liver and body size phenotypes on diabetes risk
Cardiovascular diabetology, 2015
We aimed to determine the association between nonalcoholic fatty liver disease (NAFLD) and diabetes risk among body size phenotypes which was based on cross-classification of body mass index (BMI) categories (normal or overweight/obesity) and metabolic status (metabolically health or metabolically at-risk). We conducted a cross-sectional analysis using a cohort of 10,761 apparently healthy Chinese adults who underwent comprehensive health checkups including abdominal ultrasonography. Subjects were classified as metabolically at-risk by having any two of the following, consistent with the Adult Treatment Panel-III metabolic syndrome definition: (1) systolic/diastolic blood pressure ≥130/85 mmHg, (2) triglycerides ≥1.7 mmol/L, (3) fasting blood glucose ≥5.6 mmol/L, (4) HDL-cholesterol ≥1.0/1.3 mmol/L for men/women. Among participants without metabolically at-risk, multivariate-adjusted odds ratios (ORs) for diabetes from NAFLD compared with those without NAFLD in the normal-weight (BM...
Metabolic syndrome and related disorders, 2015
To assess the prevalence of nonalcoholic fatty liver (NAFL) in Iran and to evaluate correlates of NAFL in categories of body mass index (BMI). Using a cluster random sampling approach, 7723 subjects over 18 years of age underwent abdominal ultrasonography, laboratory evaluations, blood pressure, and anthropometric measurements and were interviewed to obtain baseline characteristics. Prevalence of NAFL according to BMI and waist to hip ratio and its association with metabolic abnormalities in categories of BMI were assessed in multivariate analysis. The overall prevalence of NAFL was 35.2% [95% confidence interval (CI) 34.1-36.3]. A significant number of subjects with BMI <30 had NAFL [22.1% (CI 21.0-23.2)]. Waist to hip ratio for 38.2% (CI 35.6-40.8) of the subjects with NAFL, and BMI <30 was higher than normal values. The odds ratio for association of NAFL and dyslipidemias were higher in subjects with BMI <30 versus those with BMI ≥30: (1) hypertriglyceridemia: 2.21 vs. 1...
Integrative Gastroenterology and Hepatology, 2019
Background: Non-alcoholic fatty liver disease (NAFLD) is now predominant globally due to increased sedentary lifestyle and obesity. Recently, high prevalence of NAFLD also has been documented in non-obese individuals with increased risk of cirrhosis and hepatocellular carcinoma. The systemic and hepatic manifestations of NAFLD severity in obese and non-obese Indian patients are not clear.Methods: The clinically diagnosed NAFLD patients (n=54, non-obese and obese) were assessed for liver injury and hepatic fat content by histopathology, Fibroscan and MRS. Liver biopsy and hepatic venous sampling were performed by trans-jugular approach and mRNA expression was assessed by real-time PCR.Result: High liver fat content (LFC, 20. 4 ± 10. 4%, 16 ± 11. 5% and 9. 34 ± 15. 4%) and increased abdominal obesity (WHR, 1. 03 ± 0. 06, 0. 97 ± 0. 05 and 0. 93 ± 0. 06) was observed in both obese and non-obese NAFLD patients as compare to disease control. Histopathological examination of liver indicat...
Journal of clinical and experimental hepatology, 2015
Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multidisciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists. This position paper which is a combined effort of the Indian National Association for Study of the Liver (INASL), Endocrine Society of India (ESI), Indian College of Cardiology (ICC) and the Indian Society of Gastroenterology (ISG) defines the spectrum of NAFLD and the association of NAFLD with insulin resistance and metabolic syndrome besides suggesting preferred approaches for the diagnosis and management of patients with NAFLD in the Indian context.