FREQUENCY OF NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS (original) (raw)
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A clinical study of non-alcoholic Fatty Liver disease in Type 2 Diabetes Mellitus
2017
Background: Non-alcoholic fatty liver disease (NAFLD) is no longer considered a benign condition and has been identified as a common cause of chronic liver disease globally. Methods: This study was done on 199 cases of Type 2 Diabetes Mellitus with proper history, thorough clinical examination, including exact height, weight with relevant investigations. Results: The prevalence was 65.8%. Evidence of NAFLD was noted in 59.15% of male and 82.45% of female. Most of the cases were asymptomatic and hepatomegaly was the only commonest physical sign. 83.47% participants with high BMI were found to have NAFLD. The mean of fasting, post-prandial glucose levels and that of HbA 1 C in NAFLD, were significantly higher as compared to that with normal liver. The mean AST, ALT and ALKP levels were significantly higher as compared to the normal liver group. The ratio between AST and ALT was found to be 0.96. The mean of the total cholesterol, triglycerides and LDL were found significantly higher i...
Clinical spectrum of non-alcoholic fatty liver disease in diabetic and non-diabetic patients
BBA Clinical, 2014
a b s t r a c t 1 2 diabetic NAFLD patients . The importance of DM in NAFLD is 61 reflected by its inclusion in the majority of the non-invasive composite 62 predictive scores for NASH and advanced fibrosis [11][12][13][14]. One such 63 composite predictive score for predicting advanced fibrosis in NAFLD 64 is the NAFLD fibrosis score (NFS), which has been validated and recom-65 mended for use in the American society guidelines Q16 [2,14]. Reiterating 66 disease heterogeneity and that NAFLD may not conform to a "one size 67 fits all approach", McPherson and colleagues had reported a difference 68 in the reliability of NFS in the context of normal and abnormal ALT 69 levels [15]. Other non-invasive fibrosis scores such as the BARD score 70 and AST/ALT ratio have also been used to predict advanced fibrosis in 71 NAFLD. We sought to characterise the clinical spectrum of NAFLD in 72 patients with and without DM. In addition, we explored the utility of 73 NFS and other established non-invasive fibrosis scores among these 74 two groups.
Background: Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) may coexist in many individuals. This study was conducted to observe the frequency of NAFLD in Bangladeshi T2DM patients and to compare the glycemic status in T2DM patients with and without NAFLD. Materials and methods: Total 80 (eighty) previously known cases of T2DM were included as per inclusion and exclusion criteria. All patients undergo abdominal ultrasound to detect fatty liver. NAFLD was diagnosed after excluding other causes of liver diseases. Clinical and biochemical data were recorded and compared among T2DM patients with and without NAFLD. Results: Overall frequency of NAFLD in T2DM was 60%. Frequency among male and female T2DM patients was comparable (58.1% vs 62.2%, P 0.714). Frequency increases with age and highest frequency was found in age group 50-59 years (62.2%). Body mass index (BMI) and SGPT were significantly higher in NAFLD compared to non-NAFLD where age, duration of diabetes, fasting plasma glucose (FPG), plasma glucose 2 hours after breakfast (ABF) and HbA1c were comparable (BMI 27.8±4.9 vs 24.7±3.2 kg/m 2 , P 0.006; SGPT 47.0±25.3 vs 31.9±13.3 IU/L, P 0.001; age 52.5±8.2 vs 51.1±9.2 years, P 0.349; duration of DM 5.1±3.8 vs 5.7±3.1 years, P 0.460; FPG 9.1±2.8 vs 9.4±2.1 mmol/L, P0.220; ABF 14.7±4.8 vs 14.8±3.6 mmol/L, P 0.092; HbA1c 8.9±1.9 vs 8.8±1.2%, P 0.065 respectively). Conclusions: NAFLD is very common in Bangladeshi T2DM patients. Degree of hyperglycemia is comparable in T2DM patients with and without NAFLD.
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.3\_March2017/IJHSR\_Abstract.08.html, 2017
Introduction: Non-alcoholic fatty liver disease (NAFLD) and Non-alcoholic steatohepatitis (NASH) are the most common causes of liver disease in western countries. Prevalence of NAFLD is increasing even in developing countries mainly due to the increasing numbers of people with obesity or with metabolic syndrome and type 2 Diabetes Mellitus. Methods: A total of 50 type 2 Diabetes Mellitus (DM) patients were evaluated for detailed history, demographic profile, anthropometric measurements, microvascular complications of type 2 DM, routine blood investigations, and tests for current glycemic status (FBS, PP2BS, HbA1C). Patients underwent ultrasonography to detect NAFLD. Serum transaminses (ALT and AST) levels were measured in all patients and ratio of AST/ALT was calculated to see sensitivity and specificity of same in comparision to ultrasonography. Result: NAFLD was found in 32 (64%) patients out of 50 patients of type 2 DM by ultrasonography. Obesity and dyslipidemia, two important components of metabolic syndrome were found to have statistically significant association with occurrence of NAFLD in type 2 DM patients (p value: <0.01). Most of the patients (87.5%) in NAFLD type 2 DM group were having diabetes for more than 5 years so it seems likely that long duration of diabetes is at higher risk to develop NAFLD. There was highly statistically significant inverse relation between metformin therapy and development of NAFLD, (p value:< 0.001). It was noted that uncontrolled HbA1C level has association with increase prevalence of NAFLD (93.75%). type 2 DM patients with microvascular complications are at increased risk of developing NAFLD (p <0.005). Increased ALT levels (Sensitivity 59.38%, and Specificity 94.44%) and AST/ALT ratio less than one (Sensitivity 96.87% and Specificity 77.78%) were observed more frequently in NAFLD patients as compared to AST (Sensitivity 0 and Specificity 100%), so increased ALT and AST/ALT ratio can be used as biochemical marker to detect chronic liver disease such as NAFLD. Conclusion: High prevalence of NAFLD is seen in Indian type 2 DM population. In our study we demonstrated the association between elements of metabolic syndrome, duration of diabetes, increase HbA1C level and microvascular complications of diabetes mellitus with occurrence of NAFLD. Metformin therapy may have protective role in development of NAFLD especially in type 2 DM. Our study also highlighted importance of evaluation of aminotransferases level in type 2 DM, which can be used as marker for chronic liver disease, like NAFLD in type 2 DM.
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.
The Journal of the Association of Physicians of India
Background: Type 2 diabetes mellitus (T2DM) patients potentially are at risk of developing non-alcoholic fatty liver disease (NAFLD), Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in developing and developed countries, Global prevalence of NAFLD is 25.24% with highest prevalence in the Middle East and South America and lowest in Africa. Aim of Study: This study aimed to determine the prevalence of NAFLD among T2DM patients, diagnosed by ultrasonography of liver, to study the age, sex in NAFLD and to compare liver enzymes and lipid profile between individuals with NAFLD and without NAFLD. Patients and Methods: A prospective study was conducted of 100 type 2 diabetic Patients visited a private clinic in Aden republic of Yemen, in the period from October 2017 to June 2018. Results: Total of (100 patients) type 2 diabetes mellitus ambulatory patients were selected for the study. 62 patients (62%) had NAFLD and 38 patients (38%) had normal liver on ultrasonography, the prevalence of NAFLD in the present study was 62%, Majority of the study population observed with type 2 diabetes mellitus and NAFLD were females (n=40, 65%), and 22 were males (35%), the age range of diabetic patients with NAFLD was 40-65 years, mean age 53.16 SD ±7.64, Subjects with diabetes mellitus and NAFLD had significant elevation in Alanine transaminase (ALT), cholesterol, LDL, and triglyceride than diabetic subjects without NAFLD. Conclusions: Early detection and optimum control of diabetes mellitus is important to minimize the effect of diabetes on liver. Hence, assay of serum levels of hepatic enzymes, and abdominal ultrasound to detect NAFLD should be done in all patients with T2DM as preliminary diagnostic tests.
Liver International, 2009
Background/Aims: Diabetic patients have an increased prevalence and severity of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate the prevalence and the factors associated with the presence of ultrasonographic NAFLD in type-2 diabetic individuals.Methods: In a cross-sectional design study, 180 type-2 diabetic patients were submitted to a complete clinical and laboratory evaluation and abdominal ultrasonography for NAFLD detection and grading. Statistical analysis included bivariate tests, analysis of variance (anova, for increasing severity of steatosis) and multivariate logistic regression.Results: The prevalence of ultrasonographic NAFLD was 69.4% [95% confidence interval (CI): 58.3–82.7%]. Patients with NAFLD were more obese, had a higher waist circumference and serum triglyceride and alanine aminotransferase (ALT) levels than those without steatosis. Neither diabetic degenerative complication, nor glycaemic control was associated with liver steatosis. On multivariate analysis, a high serum triglycerides level [>2.82 mmol/L, odds ratio (OR): 3.7–4.1, 95% CI: 1.2–13.3] and a high-normal ALT level (≥40 U/L, OR: 2.5–2.7, 95% CI: 1.2–5.9) were independently associated with hepatic steatosis, together with either the presence of obesity (OR: 7.1, 95% CI: 3.0–17.0) or of increased waist circumference (OR: 4.8, 95% CI: 1.9–12.2).Conclusions: Type-2 diabetic patients have a high prevalence of ultrasonographic NAFLD and its presence is associated with obesity, mainly abdominal, hypertriglyceridaemia and high-normal ALT levels. Non-alcoholic fatty liver disease in diabetic patients may develop and progress independent of the diabetes progression itself.