Title: To Study the Prevalence of Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes and to Correlate it with Lipid profile and Glycated Hemoglobin in a Hospital
Authors: Tejesh Krishna Ch, G. S. Kochhar, V.S. Isser, Subhash Narang, Chaitanya Krishna N Shobhit Shah
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.70
Abstract
As incidence of diabetes is continuously increasing in india and diabetic dyslipidemia is a leading cause of non Alcoholic fatty liver disease which may progress to cirrhosis and hepatocellular carcinoma. No proven treatment is available to treat NAFLD. It can be prevented or its progression may be attenuated by early treatment of dyslipidemia in diabetes.
Material and Methods: - A hospital-based prospective study was carried out in 200 diabetic patients, 100 of them found to be on statin therapy for diabetic dyslipidemia for at least 3 months from history, above 35 years age including both sexes irrespective of community or background which were present in inpatient department of medicine, Mata Chanan Devi hospital, New Delhi, during the time period of 2014-2016. It is a 210 bedded, tertiary care hospital in west Delhi, where the patients travel from all northern India.
Results: - 91 of the 200 were found to have NAFLD by ultrasonography. The demographic and lipid profile such as total cholesterol, serum triglycerides, serum HDL, serum LDL and serum VLDL were recorded. The mean age of the patients was male 66.46±11.83 and female 62.96±11.16 years. Mean BMI in non-NAFLD statin group 26.48, non-NAFLD non-statin group 26.77, NAFLD statin group 29.14 and NAFLD non-statin group 30.08 (not significant). 54% of patients with metabolic syndrome and only 6% of non metabolic syndrome patients had NAFLD. Prevalence of various grades of NAFLD in statin vs. non statin groups, total (33 vs. 58%), grade 1 (21 vs. 49%), grade 2 (7 vs.8%), grade 3 (1 vs.5%). Mean of various serum lipid parameters in statin vs. non statin groups is total cholesterol (117.9 vs. 171.53), TG (120.13 vs. 184.49), LDL (60.27 vs. 99.26), VLDL (24.04 vs. 36.21), non-HDL (84.3 vs. 136.16) with p value <0.05 (significant), HDL (37.89 vs. 39.7).The total prevalence of NAFLD in diabetics was found to be lower than was found in various other studies, this was found to be associated to the statin therapy that 100 of the total group was already on at time of study for >3 months. Diabetics on statin therapy are found to have a significantly lowered lipid parameters and also lower prevalence of NAFLD than non statin group. No significant difference was noted in the liver enzymes and ECG changes.
Conclusion: - Thus our study has found that statins not only improve the diabetic dyslipidemia but also reduces the prevalence of NAFLD and is also safe.
Recommendation: - Large randomized double blind trails are needed to prove the drug effects.
Keywords: NAFLD, diabetes, statin, metabolic syndrome, lipid parameters.
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