Title: Pattern of Non Alcoholic Fatty Liver Disease in Coronary Artery Atherosclerosis in Central India
Authors: Dr Vijay Kumar Nandmer, Dr Ajay Kumar Nandmer
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.93
Abstract
Introduction
Patients with NAFLD were associated with more prevalent CAD independent of other risk factors, including glycemic control and Met S components. This finding was despite factoring in the other risk factors for CAD and the components of metabolic syndrome. In patients with NAFLD, metabolic abnormalities are commonly found and vary from 33 to 100% depending on types of study and the selection criteria of NAFLD patients. The criteria of MetS by the International Diabetes Federation in 2005 considers mandatory the presence of abdominal obesity as measured by waist circumference(WC) with ethnicity specific, plus any two of other criteria, which is different from those in the ATPIII definition(67).
Coronary artery atherosclerosis begins at young ages and typically becomes symptomatic after middle-aged with various clinical signs including acute coronary syndrome (ACS)
Material and Methods: The study will be conducted in the Department of Medicine and Department of Cardiology at Gandhi Medical College and Hamidia Hospital, Bhopal. The study subjects will be selected from amongst the patients who attend the Medicine OPD, Cardiology OPD and admitted in the Cardiology WARD of Hamidia Hospital, Bhopal.
Type of Study: Observational Cross-Sectional Study
Inclusion Criteria
150 proven CAD patients will be included in the study
Proven CAD patients will be defined either as ECG changes or Echocardiographic findings of RWMA.
100 non CAD patients will be included in the control group. Non CAD patients will be defined on the basis of no significant cardiac history, no ECG changes and normal echocardiograph.
Exclusion Criteria
1. Documented liver disease.
2. history of alcohol intake of more than 20 gms of alcohol per day.
3. Drug history
Summary & Conclusion
The summary of the study is as follows
The study shows prevalence of NAFLD in CAD and CONTROL group is 48.66%.and 22% respectively. Prevalence of NAFLD in males is 44.56% and 22.95% & in females it is 55.17% and 20.51% respectively.
The study shows that mean BMI is higher in patients with NAFLD in both males and females as compared to that in Non NAFLD group.
The study shows that mean waist/hip is higher in patients with NAFLD in both males and females as compared to that in Non NAFLD group.
Incidence of NAFLD is more in Hypertensive CAD group as compared to that of Hypertensive Control group.
Incidence of NAFLD is more in Diabetic CAD group as compared to that of Diabetic Control group.
In our study we found that there is no positive correlation of smoking with NAFLD
Thus we conclude that prevalence of NAFLD is higher in CAD population. Further prevalence of NAFLD increases with other CAD risk factors i.e. hypertension, DM-2, central obesity, High BMI and dyslipidemia. Thus it can be concluded that presence of NAFLD with these risk factors further increases cardiovascular morbidity as depicted by higher CRP positive patients in this group.
In our study we found that patients of NAFLD in CAD group have higher fasting blood glucose levels, more dyslipidaemia, higher SGOT/SGPT levels, more incidence of Hypertension, thus retrospectively we can conclude that patients with NAFLD with these risk factors have higher incidence of CAD and should be screened for the same.
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