PREVALENCE OF NONALCOHOLIC FATTY LIVER DISEASE IN TYPE 2 DIABETES MELLITUS

Abstract

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. Nonalcoholic fatty liver disease is commonly associated with obesity, type 2 diabetes mellitus, dyslipidemia and insulin resistance-components of metabolic syndrome. This strongly supports the notion that NAFLD is hepatic manifestation of metabolic syndrome. 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. There are very few reports about the prevalence of NAFLD in T2DM patients. To highlight the problem and as this study has not been done in this part of state it has been taken for the study. The aim of this study is determine prevalence of NAFLD in Type 2 Diabetes mellitus and to find liver function abnormalities in Type 2 Diabetes mellitus. XII METHODS: This study was carried out in B.L.D.E.U’s Shri B.M. Patil Medical College Hospital and Research Centre, Vijayapur, Karnataka; during the period from November 2013 to June 2015. 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: The mean age of patients include in study was 59.7±12 years, majority with age group of 56-65 years. 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. Elevated levels 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, making obesity an important association. Triglyceride levels was found higher in patients with NAFLD compared to patients without NAFLD and was statistically significant with p value of 0.003. Higher prevalence of retinopathy (p=0.01), nephropathy (p=0.01), and coronary artery disease (p=0.03) were found in patients with patients with NAFLD. 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, nephropathy and retinopathy 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.