A study of prevalence of non-alcoholic fatty liver disease in type 2 Diabetes Mellitus (original) (raw)
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Diagnostics, 2020
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Comparison of Serum Ferritin Levels in Nafld Patients and Healthy Controls
Pakistan Armed Forces Medical Journal, 2020
Objective: To determine and compare serum ferritin levels in non-alcoholic fatty liver disease (NAFLD) patients of our ethnicity. Study Design: Cross sectional comparative study. Place and Duration of Study: The study was conducted at Radiology department of Shalamar Hospital, Medical OPD of Combined Military Hospital, Lahore and Medical OPD of Omer Hospital, Lahore, from Jul 2015 to Sep 2015. Methodology: A total number of 43 non-alcoholic fatty liver disease patients diagnosed after ultrasonography were included in the study. An equal number of age, gender and body mass index (BMI) matched healthy controls were selected by non-probability purposive sampling. Fasting serum ferritin levels, body mass index and waist circumference were measured in both the cases and controls. Data were entered and analyzed on SPSS 21.For quantitative data median IQR was calculated. Mann Whitney U-test was used for group comparison. To find an association, Spearman‟s Ranked correlation was applied. A ...
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.
Systematic Reviews in Pharmacy
Background: NAFLD is the chronic form of liver fatty disease, which is vastly common over all worldwide. It is highly connected with T2DM that is defined by hyperglycemia, insulin resistance (IR), and hepatic malfunctions. Our study was design to determine the predictors for NAFLD' incidence in T2DM patients. Methods: We conducted study of 299 subjects that were classified into two groups, (110) Non-Diabetic subjects and (189) T2DM patients, then the T2DM patients divided into two groups: T2DM (99) and DM+pre-NAFLD (90) patients. We measured hyperglycemia tests, Total Cholesterol, Triglycerides (Tg), Low-Density Lipoprotein Cholesterol (LDL-C), High Density Lipoprotein Cholesterol (HDL-C), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), AST/ALT ratio, and γ-Glulamyltransferase for all groups. We determined the Triglyceride Glucose index, Interleukin-6, Alkaline Phosphate (ALKP), and C Reactive Protein (CRP) levels as biomarkers for IR and NAFLD respectively. Results: Our data demonstrated that DM+pre-NAFLD patients exhibited a significant increased in TC, TG, and LDL-C, and dramatic decreased in HDL-C compared to DM patients and Non-DM subjects.-AST, ALT, AST/ALT ratio and GGT levels showed a significant elevation in DM+pre-NAFLD and DM patients compared to the Non DM subjects. The data showed that TyG Index, IL-6, CRP and ALPK levels were increased in DM+pre-NAFLD patients only. The data showed a positive correlation between dyslipidemia, and liver function tests with IR and NAFLD biomarkers in DM+pre-NAFLD patients only. Conclusions: In T2DM, dyslipidemia deters liver enzymes functions, promotes the IR and increases the fatty liver accumulation. Liver enzymes, TyG Index, IL-6, CRP and ALPK could be non-invasive biomarkers for NAFLD in T2DM patients.
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.
Prediction of NAFLD occurrence in prediabetes patients
Experimental and Therapeutic Medicine, 2020
Non-alcoholic fatty liver disease (NAFLD) is a component of metabolic syndrome that significantly increases the cardiovascular risk of patients with glucose metabolism alterations. This study identified the prevalence of NAFLD, predictors of NAFLD and explored the link between insulin sensitivity, insulin resistance and leptinemia in 143 patients registered with prediabetes. Abdominal ultrasound was performed, and fasting insulin, postprandial insulin, leptin levels, common clinical/biochemical determinations were assessed. Certain variables that can predict NAFLD existence were determined and it was found that there is a high prevalence of NAFLD in patients with prediabetes. In univariate analysis, statistically significant associations (P<0.05) were found between waist circumference, systolic blood pressure, diastolic blood pressure, triglycerides, HDL-cholesterol, insulin sensitivity, β-cell function, leptin and NAFLD presence. The coefficients for the variables which obtain statistically significant association (P<0.05) are low, except for leptin which is the biochemical parameter that (in both univariate and multivariate analysis) is a strong predictor of NAFLD presence.
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.
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.
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.