“Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome In Type 2 Diabetes Mellitus Patients in Rajshahi Medical College Hospital, Rajshahi, Bangladesh” (original) (raw)
Related papers
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 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.
Non-alcoholic fatty liver disease (NAFLD)--the hepatic component of metabolic syndrome
The Journal of the Association of Physicians of India, 2009
To study the prevalence of NAFLD in those patients attending the routine health checkup and to establish a relationship between NAFLD and metabolic syndrome. All patients attending the health check-up had their blood pressure, height and weight, waist circumference measurements, blood sugars, lipid levels and ultrasound abdomen done. The prevalence of NAFLD among these subjects was determined and the presence of risk factors for metabolic disease in each individual was analysed. A relationship between NAFLD and metabolic syndrome was then established. Of the 1003 people 225 (22.6%) had NAFLD with higher prevalence among males 164/565 (29%) than among females 61/438 (13.9%). In the NAFLD group normal body mass index (BMI) was present in only 49/225 (20%) of the subjects while 119/225 (52.8%) were overweight and 56/225 (24.8%) were obese. Though liver enzymes were normal the mean AST among cases was 37.41 +/- 14.50 and 33.93 +/- 14.15 among controls and the mean ALT was 38.74 +/- 17.9...
British Journal of Medicine and Medical Research, 2015
Backgrounds: Non-alcoholic fatty liver disease (NAFLD) has become one of the major health problems world widely, especially among communities with sedentary lifestyle. The main objectives of this study were to know the prevalence of NAFLD among Saudi patients with T2DM in Jazan region and to determine the most important associated factors. Materials and Methods: A cross sectional study targeted 230 type 2 diabetic patients, who attended Diabetic Center at Jazan General Hospital. All participants were screened for NAFLD Elmakki et al.; BJMMR, 5(7): 872-879, 2015; Article no.BJMMR.2015.094 873 using abdominal ultrasonography in addition to clinical and laboratory workup. Descriptive statistics, Chi square/Fisher exact test and logistic regression were utilized for data analysis. Results: The prevalence of fatty liver in the present study was 47.8% (95% CI 41.1-54.6), with no significant difference between males 49.1% (95% CI 40.0-58.3) and females 46.3% (95% CI 36.6-56.3). The prevalence of NAFLD was found to be 52.9% among patients who their ages range between 40-59 years. Factors associated with NAFLD were found to be age, uric acid, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (p-value<0.05 for all). Conclusion: NAFLD is tremendously common among people with type 2 diabetes in Jazan region and the major associated factors were age, obesity, uric acid and elevated liver enzymes. There was no positive correlation between the presence of fatty liver and duration of DM or the degree of glycemic control.
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.
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).
Backgroun: Type 2 diabetes mellitus (T2DM) and Nonalcoholic fatty liver disease (NAFLD) have risen globally to epidemic proportions. The study was aimed to determine the prevalence of NAFLD and its association with cardiometabolic risk factors in T2DM subjects. Method: In a case control study, 212 consecutive, T2DM subjects with age ≥ 30 years, were evaluated from December 2017 to December 2018 at Mahatma Gandhi Medical College &Hospital, Jaipur, Rajasthan. Subjects with history of significant alcohol consumption, evidence of cirrhosis, hepatotoxic drugs, and other known causes of fatty liver were excluded. The T2DM subjects were divided into (1) NAFLD -patients with USG evidence of fatty changes in the liver (2) Non-NAFLDpatients without any USG evidence of fatty changes in the liver. Coronary artery disease was screened by any past medical history of CAD or electrocardiographic or angiography evaluation. Continuous variables were expressed as mean with standard deviation.
To Study the Occurrence of Non-Alcoholic Fatty Liver Disease (NAFLD) in Type -II Diabetes Mellitus
The Journal of the Association of Physicians of India, 2020
Background: Macrovascular and Microvascular complications are well evaluated in DM but NAFLD is the most neglected and unevaluated complication among DM.Fibroscan is the non-invasive method for assessing liver fibrosis which has high reproducibility and accuracySubjects and Methods: It was a Case Control study. Fibrosis was assessed by fibroscan and was then quantified. Results: In our study there was a significant difference seen among the different grades of fibrosis among controls and cases (p=0.004). The mean fibrosis score too was high among cases (13.498) as compared to controls (6.052). The overall prevalence of NAFLD (F2-F4) was found to be 50% among cases as compared to 14% in controls.Conclusion: Diabetes has a significant etiological role in occurrence of NAFLD in population. Fibroscan has a substantial role in screening and diagnosing diabetics for NAFLD and fibrosis, thus advocating its use is recommended to prevent understudied and unrecognized complication of DM preventing mortality and morbidity.
Prevalence of nonalcoholic fatty liver disease in type 2 diabetes mellitus
Background and objectives: Microvascular and macrovascular complications of Type 2 DM are well studied, but association of T2DM with Non alcoholic fatty liver disease (NAFLD) has been recognized recently. The prevalence of NAFLD amongst T2DM is higher compared to non diabetics. There is evidence that T2DM patients with NAFLD are at higher risk of developing cirrhosis compared to non diabetics. Recent data suggest that the prevalence of NAFLD may also be linked to increased coronary artery disease risk, independent of risk conferred by the elements of metabolic syndrome. Indentifying people with NAFLD would also highlight a subgroup of diabetic patients who would be targeted to decrease their risk of future CAD events.. A total of 122 patients who were known case of Type 2 diabetes mellitus and who satisfied inclusion criteria were included in the study. Results: Out of 122 patients included in study 58(47.5%) had NAFLD, the most common sonographic grade of NAFLD was mild fatty liver (62%), followed by moderate (36%), then severe fatty liver (2%). The mean SGOT, SGPT and ALP levels were 31±14.4 IU/L, 25±14.2 IU/L and 104±47.6 respectively. An elevated level of ALP was found to be significantly higher in patients with NAFLD compared patients without NAFLD. 58.6% patients with NAFLD had BMI above normal compared to 36.2% of patients without NAFLD who had elevated BMI which is statistically significant p=0.0001 Conclusion: Prevalence of NAFLD was 47.5% in T2DM patients was significantly associated with overweight, obesity, raised levels of TG, VLDL, ALP. Microvascular complications of T2DM were found to be significantly higher in patients with NAFLD. Macrovascular complication of T2DM Coronary artery disease was found to be significantly higher in patients with NAFLD.
A study of prevalence of non-alcoholic fatty liver disease in type 2 Diabetes Mellitus
Innovative Publication, 2016
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.