Abstract
Background: Non Alcoholic Fatty Liver Disease (NAFLD) is becoming modern hepatic pandemic and NAFLD co-existing in patients with diabetics is supposed to have reduced beta cell function. Patients with NAFLD who have type 2 diabetes are particularly at risk of developing NASH and they are at higher risk of developing cirrhosis, also have poor glycemic control owing to reduced beta cell function. So identifying the patients with diabetes having NAFLD and β cell functional status could estimates the future risk and help in slowing the progression and prevention of chronic liver disease and various complications of Diabetes.
Material: This was a cross sectional observational study conducted in department of medicine, N.S.C.B., MCH, Jabalpur in which 100 cases of diabetes were taken who satisfied inclusion and exclusion criteria. Abdominal USG was used for evidence of fatty liver and it’s grading and fasting serum levels of insulin (FIL) and fasting blood sugar (FBS) were used to calculate HOMA-β value to get beta cell function.
Observation: HOMA-β values were calculated for all the patients of DM, which showed that lower mean HOMA-β values in patients with NAFLD and Diabetes i.e.37.56±24.03 as compared to 60.96±96.62 in Non NAFLD group of patients. β cell function was deranged in the patients with high BMI, Waist circumference. NAFLD group of patients have higher prevalence of diabetes related complications as compare to Non NAFLD group. Prevalence of NAFLD was slightly more in females-56.6%(n=30) as compared to males-55.32%(n=26).We found higher Mean BMI, Waist circumference, Triglycerides, FBS,FIL in cases with NAFLD (24.83±2.42, 95.11±12.46, 180.07±51.35, 176.13±66.79, 13.59±15.42) as compare to non NAFLD (22.41±2.16, 85.84±9.86, 139.09±39.27, 134.8±34.41, 6.79±4.49) respectively. Lower HOMA-β values were significantly associated with raised BMI and WC.
Conclusion: As NAFLD is highly prevalent in diabetics, possibility of NAFLD should be considered in all of them. Patients with Diabetes who also have NAFLD, observed to have relatively reduced β cell function, However it is not significantly associated with Non NAFLD group probably because of already reduced β cell function reserve in diabetics However progressive decline in β cell function could estimate future risk of NASH and complications of diabetes. It seems reasonable to expect that early diagnosis of NAFLD and early intervention with strict glycemic control and weight loss would prevent complications.
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Corresponding Author
Dr Shivesh Thakur
Resident Medical, Officer, N.S.C.B.M.C.H. Jabalpur, M.P.
Address-16th Shivarth Residency, Jasuja City, Dhanvantari Nagar, Jabalpur, Pin-482003
Contact no.+917415209963, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i12.47
