Cardiovascular Morbidity in Diabetic Non-Alcoholic Fatty Liver Disease (NAFLD) Using NAFLD Fibrosis Score as an Early Indicator (original) (raw)
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International Journal of Clinical Trials, 2015
Background: Recently non-alcoholic fatty liver disease (NAFLD) has been suggested as independent cardiovascular (CVD) risk factor and many studies have shown strong links between NAFLD and CVD but NAFLD has not been related to cardiovascular mortality independently on a long term follow up. Inflammation and oxidative stress is well recognized factors for NALFD which lead to many interrelated factors contributing to cardiovascular risk. Aim: To study the cardiovascular disease risk in diabetes and metabolic syndrome patients with and without NAFLD using different risk assessment calculators. Methods: This was a single center, prospective cross sectional study. 62 patients with diabetes and metabolic syndrome attending the endocrinology & gastroenterology clinics of Osmania General Hospital were enrolled in to the study with 31 patients in group A (NAFLD) and 31 patients in group B (Non-NAFLD). Patients were diagnosed with fatty liver by ultrasound examination. Results: The groups were individually evaluated for cardiovascular risk assessment by PROCAM risk score, atherosclerotic cardiovascular disease (ASCVD) score and atherosclerosis Index. The means ± standard(%) deviation of Procam risk score for NAFLD group was 6.00 ± 1.00 and for Non NAFLD group it was 10.00 ± 2.00 (p=0.039). ASCVD risk score shows 5.11 ± 1.12 for NAFLD and Non NAFLD group showed 8.25 ± 2.18 (p=0.235). The Atherosclerosis index for NAFLD group was 0.24 ± 0.03 and Non NAFLD 0.18 ± 0.04 (p=0.785). The QRsik2 score for NAFLD and Non-NAFLD patients was 13.16 ± 7.56 and 17.45 ± 10.36. Conclusions: There was no difference in CVD risk assessment when assessed with different calculators in this population.
Noninvasive tool for the diagnosis of NAFLD in association with atherosclerotic cardiovascular risk
Egyptian Liver Journal, 2019
Background Whether the severity of liver histology in non-alcoholic fatty liver disease (NAFLD) is associated with more pronounced cardiovascular disease is unsettled. There is a need to develop a noninvasive tool to help its diagnosis in association with atherosclerotic cardiovascular disease. We aimed to evaluate the diagnostic performance of NAFLD-liver fat score (NAFLD-LFS) and carotid intima-media thickness (CIMT) in magnetic resonance imaging-proved NAFLD. The study comprised 60 patients with NAFLD during the period from October 2015 to June 2017, diagnosed by clinical features, laboratory tests, and magnetic resonance study. Thirty healthy subjects served as controls. All included individuals were subjected to anthropometric measurements and measurement of NAFLD-LFS and CIMT. Results On doing ultrasonography, 30 cases showed mild, 24 showed moderate, and 6 cases showed severe steatosis. NAFLD-LFS at a cutoff value of − 1.628 showed a sensitivity of 96.7%, specificity 100%, po...
International Journal of Hepatology
Background. The study was designed to assess cardiovascular risk factors flow-mediated dilatation % (FMD%) and carotid intima-media thickness (CIMT) in NAFLD. Methods. 126 NAFLD subjects and 31 chronic hepatitis B (CHB) controls were studied. Measuring carotid intima-media thickness (CIMT) and the flow-mediated dilatation % (FMD%) by brachial artery Doppler ultrasound were used to assess atherosclerosis. The risk of cardiac events at 10 years (ROCE 10) was estimated by the Prospective Cardiovascular Munster Study (PROCAM) score. Results. 58 of 126 NAFLD have coexistent metabolic syndrome. Mean CIMT was 0.73±0.041 mm among NAFLD with MS, 0.66±0.016 mm among NAFLD without MS, and 0.66±0.037 in controls CHB patients. FMD% in NAFLD with MS was 10.43±3.134%, but was 8.56±3.581% in NAFLD without MS and 17.78±6.051% in controls. PROCAM score of NAFLD with MS was 46.95±6.509 while in NAFLD without MS was 38.2±3.738. Controls had a PROCAM score of 38.13±5.755. ROCE 10 in NAFLD with MS was 13...
The Burden of NAFLD and Its Characteristics in a Nationwide Population with Type 2 Diabetes
Journal of Diabetes Research, 2016
Objective. We studied the prevalence of nonalcoholic fatty liver disease (NAFLD) and its clinical correlates in a population of patients with type 2 diabetes mellitus (T2DM).Methods. Clinical data of 94,577 T2DM patients were retrieved from 160 diabetes clinics in Italy in a standardized format and centrally analyzed anonymously. After exclusion of 5967 cases (high or uncertain alcohol intake), in 38,880 the Fatty Liver Index (FLI) was used as a proxy for the diagnosis of NAFLD. Factors associated with FLI assessed NAFLD (FLI-NAFLD) were evaluated through multivariate analysis.Results. FLI-NAFLD was present in 59.6% of patients. Compared to non-NAFLD, FLI-NAFLD was associated with impairment in renal function, higher albumin excretion, HbA1c and blood pressure, lower HDL cholesterol, and poorer quality of care. ALT was within normal limits in 73.6% of FLI-NAFLD patients (45.6% if the updated reference values were used). The prevalence of FLI-NAFLD did not differ if the whole sample ...
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.
Clinical Profile of Nafld Patients and Its Correlation with Metabolic Syndrome
Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a clinico-pathological entity, increasingly recognised as a major health burden in developed countries and the fastest rising form of chronic liver disease worldwide. It is gaining concern among physicians in developing countries as well as it is predicted that its prevalence may surpass that of chronic hepatitis. It includes a spectrum of liver damage ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), advanced fibrosis and rarely progression to cirrhosis. MATERIALS AND METHODS This was a descriptive study conducted in Department of Medicine, SSMC and SGMH, Rewa. A total of 200 cases were included in the study, who were diagnosed as having fatty liver on the basis of ultrasonography (USG) during the study period of April 2016 to July 2017 and were further investigated for metabolic syndrome. RESULTS Out of 200 cases, 55.5%, 36% and 8.5% of cases had grade I, II and III fatty liver respectively. 128 (64%) had metabolic syndrome. 63.93%, 61.11% and 76.84% of grade I, II and III NAFLD patients suffered from metabolic syndrome respectively. All the components of metabolic syndrome were significantly associated with NAFLD (p ≤ 0.05).
World Journal of Gastroenterology, 2014
Core tip: The purpose of this clinical review is to summarize the rapidly expanding body of evidence that supports a strong association between Nonalcoholic fatty liver disease (NAFLD) and cardiovascular, cardiac and arrhythmic complications, to briefly examine the putative biological mechanisms underlying this association, and to discuss some of the current treatment options that may influence both NAFLD and its related cardiac and arrhythmogenic complications.
Journal of clinical gastroenterology, 2017
The aim of our study is to assess the prevalence of nonalcoholic fatty liver disease (NAFLD) and advanced hepatic fibrosis in patients with type 2 diabetes mellitus (T2DM) using simple noninvasive scores. In individuals with T2DM, there is a very high prevalence of NAFLD. Moreover, T2DM is a risk factor for advanced disease in NAFLD patients. Using International Classification of Diseases, Ninth Revision codes all patients with the diagnosis of T2DM were reviewed and a retrospective chart analysis was performed on 169,910 patients between the ages of 18 to 80. To predict the prevalence of NAFLD, we calculated the hepatic steatosis index. To estimate the prevalence of advanced fibrosis, NAFLD fibrosis score (NFS), fibrosis-4 index, aspartate aminotransferase (AST) to platelet ratio index (APRI), and AST/alanine aminotransferase (ALT) ratio were calculated. Of the 121,513 patients included in the analysis, 89.4% were above normal weight limit. NAFLD based on Hepatic Steatosis Index>...
2021
Background: Cardiovascular-related mortality is a major concern in NAFLD. Advanced fibrosis was known to be associated with cardiovascular diseases. NAFLD Fibrosis Score (NFS) is used to identify the development of liver fibrosis in NAFLD patients. Left ventricular mass index (LVMI) is a sign of subclinical cardiovascular complications in NAFLD. The correlation between NAFLD fibrosis score with LVMI in NAFLD patients is not fully established. Objective: To analyze the correlation between NAFLD fibrosis score with LVMI in NAFLD patients. Methods: A cross-sectional study of NAFLD patients in Kariadi Hospital Indonesia. NFS was calculated using a formula based on clinical and biochemical parameters. LVMI was measured with echocardiography. Pearson's, Mann-Whitney, and logistic regression were used for analysis. Results: A total of 64 patients with primary NAFLD were enrolled, 54.7% males and 45.3% females. Mean age was 52.8 ± 10.5 years (30-77 years). Based on NFS criteria, the high probability group was most prevalent (50%), followed by intermediate probability group (34.4%) and low probability group (15.6%). Highest increase in LVMI was obtained in the high probability group (93.8%), followed by intermediate probability (59.1%), and low probability group (10%) respectively. There was significant correlation between NFS and LVMI (P 0.002). Logistic regression showed that NFS has a more significant correlation with LVMI compared to gender (P=0.002). Conclusion: NFS is a non-invasive liver fibrosis score which independently correlates with Left ventricular mass index (LVMI), a marker of cardiovascular abnormality.
Type 2 Diabetes; Non Alcoholic Fatty Liver Disease (Nafld)
The professional medical journal, 2016
To determine the prevalence and the associated risk factors of NAFLD in Type 2 diabetic patients. Study Design: Cross sectional study. Setting: Diabetic clinic of Medical Unit 3, JPMC. Methods: It is a cross sectional study. 262 patients were enrolled between the ages of 18-70 years attending Diabetes Clinic of Medical Unit III, JPMC. Each consenting patient underwent a detailed medical history-taking, physical examination, laboratory assessment and abdominal ultrasonography (US). Fatty liver was diagnosed on abdominal US on the basis of two out of the three criteria: increased hepatic echogenicity, blurring of liver vasculature and deep attenuation of the ultrasonographic signal. In accordance with the guidelines, subjects diagnosed with NAFLD had to fulfill the following criteria: no history of current or past alcohol consumption, other systemic illness known to cause fatty liver disease; absence of history and clinical, biochemical and US findings consistent with cirrhosis. Body mass index (BMI) was calculated. Blood pressures of greater than 130/90 were taken as hypertensive. LFTs, FBS, HbA1c, Lipid profiles were taken. Results: Out of 262 diabetic patients 107 (40.8%) of them were found to be having NFALD. Prevalence was found out to be higher in age group of 41-50 years, females, obese & in Pashtoon subjects.It was also more prevalent in sedentary lifestyle patients and those on oral anti diabetics in contrast to insulin therapy. It was correlating well with US findings when the ALT cutoff value was taken as 30 IU for males and 19 IU for females compared to standard values of ALT. There was association with hypertension, metabolic syndrome and dyslipidemia. Conclusion: Prevalence of NAFLD was higher in our diabetic patients. Middle age, female gender and obesity were found to be statistically strong risk factors in our study.