Title: Prevalence of Non Alcoholic Fatty Liver Disease and Its Association with Cardio Metabolic Diseases in Early Diabetics

Authors: Dr Ram Prakash Pandey, Dr Balvir Singh, Dr P K Maheshwari, Dr Mridul Chaturvedi, Dr Mahendra Pratap Singh, Dr Richa Pandey

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.106

Abstract

Background: To study the prevalence of non-alcoholic fatty liver disease and its association with cardiometabolic diseases in early diabetics.

Materials and Methods: The Study was conducted on 120 diabetic patients attending the outdoor patient department and in wards of Department of medicine and diabetic clinic S.N. Medical College, Agra during the period from March 2016 to Aug 2017. After taking informed consent from the patients a detailed history physical examination and laboratory investigations carried out. NAFLD was diagnosed on the basis of ultrasonic assessment of the liver.

Results: The prevalence of NAFLD in diabetics was 56.67%. NAFLD patients were associated with metabolic syndrome components like hypertension (52.94%) (p-value=0.8045), diabetic dyslipidemia (73.53%) (p-value=0.0022), central obesity(70.58%) (p-value=0.0165), hypothyroidism (23.53%) (p-value=0.0005), hyperuricemia (20.58%) (p-value=0.0001), and deranged transaminases(47.05%) (p-value=o.8045). NAFLD patients were also associated with cardiac components like left ventricular hypertrophy (23.53%) (p-value=0.0005), systolic dysfunction (20.58%) (p-value=0.0001), diastolic dysfunction (17.65%) (p-value=0.0001), and increased carotid intima-media thickness (29.41%) (p-value=0.0081).  

Conclusion: The patients of diabetes mellitus should undergo liver function tests, ultrasonography of liver, Fibroscan and 2D echocardiography at the time of diagnosis. Early detection would help not only in modifying the disease course but would also delaying or preventing the fatal complications like steatosis, steatohepatitis, cirrhosis, and carcinoma of the liver. Accordingly the patient may be treated earliest by various measures like lifestyle modifications etc.

Keywords: Non- alcoholic fatty liver disease, metabolic syndrome, diabetics, cardiometabolic diseases

References

  1. Harrison’s Principles Of Internal Medicine Mc Graw Hill Education, Manal F Abdelmalek, Anna Mae Diehl 19th Edition, 2054-2057.
  2. Ruhl CE, Everhart J. Epidemiology of non-alcoholic fatty liver disease. Clin Liver Dis.2004;8:501-19
  3. National Cholesterol Education Programme: Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285 : 2486-2497.
  4. Kalra S, Vithalani M, Gulati G, et al (2014) Study of prevalence of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes patients in India (SPRINT). 2014 J Assoc Physicians India.
  5. Jonathan M. Hazlehurst , Conor Woods, Thomas Marjot , et al Non-alcoholic fatty liver disease and diabetes. Metabolism Clinical and Experimental 2016; 65; 1096-1108
  6. Animesh Deb, Amitabha Chattopadhyay, Sk. Kamal Hassan, et al (2015) IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2015; 14(12): 2279-91.
  7. Rakesh Gaharwar, Sushma Trikha, Shubha Laxmi Margekar, et al. Study of Clinical Profile of Patients of Non-Alcoholic Fatty Disease and its Association with Metabolic Syndrome. Journal of the Association of Physicians of India. 2015; 63 : 12-16.
  8. Ahad Eshraghian and Alireza Hamidian Jahromi et al. (2014) Non-alcoholic fatty liver disease and thyroid dysfunction: A systematic review World J Gastroenterol 2014 July 7; 20(25): 8102-8109
  9. Kamran B. Lankarani1, Mojtaba Mahmoodi, Mehrzad Lotfi, Nima Zamiri, Sayed Taghi Heydari, Fariborz Ghaffarpasand, Mohammad Kazem Fallahzadeh, Meisam Babaeinejad, Najmeh Maharlouei, Omid Mirzaee, Bita Geramizadeh and Payam Peymani (2013)
  10. Hakan Fotbolcu, Tolga Yakar, Dursun Duman, Tansu Karaahmet, Kursat Tigen, Cihan Cevik, Unal Kurtoglu, Ismet Dindar (year) Impairment of the left ventricular systolic and diastolic function in patients with non-alcoholic fatty liver disease Cardiology Journa 2010, Vol. 17, No. 5, pp. 457–463.

Corresponding Author

Dr (Prof) Balvir Singh

Professor, P.G. Department of Medicine, Sarojini Naidu medical college, Agra-282002

Uttar Pradesh, INDIA

Mobile: +919412722223, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.