A study of non-alcoholic fatty liver disease and its relation to type 2 diabetic patients and cardiovascular risk markers

Authors

  • Manabendra Sau Department of Community Medicine, Midnapore Medical College and Hospital, Medinipur, West Bengal, India
  • Subhasish Chakraborty Department of Medicine, N.R.S. Medical College and Hospital, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20183118

Keywords:

Cardio-vascular risk, Non-alcoholic fatty liver disease, Type 2 diabetic

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a unique entity characterised by fatty changes with lobular hepatitis in absence of a history of alcoholism. Compelling evidence over the past several years has substantiated a significant link between NAFLD and cardiovascular disease ranging from coronary artery disease to subclinical carotid atherosclerosis. Close follow up, treatment of risk factors for NAFLD, and cardiovascular risk stratification are necessary to predict morbidity and mortality in these patients. The objective of this study is to find out hepatic involvement in type 2 diabetic patients and to correlate the associations between non-alcoholic fatty liver disease and different Cardiovascular risk factors.

Methods: This prospective and observational study was conducted in a tertiary care Centre, Kolkata, West Bengal and was conducted among 128 patients having patients having been diagnosed as type 2 diabetic and whose liver USG scan showing fatty changes.

Results: In the studied 128 cases, 99 patients had fatty liver and 29 cases without fatty liver diagnosed by abdominal ultrasonography. Most of the Diabetic NAFLD cases were detected in their 5th and 6th decade of life with a male preponderance. Ultrasonography remains a reliable non-invasive method for detection. Ischemic changes in ECG were noted in the study population without statistical significance probably due to low sampling.

Conclusions: Left ventricular diastolic dysfunction found to be the prime echocardiographic abnormality in type 2 diabetes mellitus patients.

References

Angulo P. Non-alcoholic fatty liver disease. N Engl J Med. 2002;346:1221-31.

Van Hoof M, Rahier J, Horsmans Y. Tamoxifen-induced steatohepatitis. Ann Intern Med. 1996;124:855.

Daniel S, Ben-Menachem T, Vasudevan G, Ma CK, Blumenkehl M. Prospective evaluation of unexplained chronic liver tranaminase abnormalities in asymtomatic and symtomatic patients. Am J Gastgroenterol. 1999;94:3010-4.

Machado M, Marques-Vidal P, Cortez-Pinto H. Hepatic histology in obese patients undergoing bariatric surgery. J Hepatol. 2006;45:600-6.

Younossi ZM, Gramlich T, Matteoni CA, Boparai N, McCullough AJ. Non-alcoholic fatty liver disease in patients with type 2 diabetes. Clin Gastroenterol Hepatol. 2004;2:262-5.

Assy N, Kaita K, Mymin D, Levy C, Rosser B, Minuk G. Fatty infiltration of liver hyperlipidemic patients. Dig Dis Sci. 2000;45:1929-34.

Hamaguchi M, Kojima T, Takeda N, Nagata C, Takeda J, Sarui H, et al. Non-alcoholic fatty liver disease is a novel predictor of cardiovascular disease. World J Gastroenterol. 2007;13:1579-84.

Haring R, Wallaschofski H, Nauck M, Dörr M, Baumeister SE, Völzke H. Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum gamma-glutamyl transpeptidase levels. Hepatol. 2009;50:1403-11.

Adams LA, Lymp JF, St Sauver J, Sanderson SO, Lindor KD, Feldstein A, et al. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterol. 2005;129:113-21.

Arulanandan A, Ang B, Bettencourt R, Hooker J, Behling C, Lin GY, et al. Association between quantity of liver fat and cardiovascular risk in patients with non-alcoholic fatty liver disease independent of non-alcoholic steatohepatitis. Clin Gastroenterol Hepatol. 2015;13:1513-20.

Söderberg C, Stål P, Askling J, Glaumann H, Lindberg G, Marmur J, et al. Decreased survival of subjects with elevated liver function tests during a 28-year follow-up. Hepatol. 2010;51:595-602.

Zeb I, Li D, Budoff MJ, Katz R, Lloyd-Jones D, Agatston A, et al. Non-alcoholic fatty liver disease and incident cardiac events: the multi-ethnic study of atherosclerosis. J Am Coll Cardiol. 2016;67:1965-6.

Targher G, Marra F, Marchesini G. Increased risk of cardiovascular disease in non-alcoholic fatty liver disease: causal effect or epiphenomenon? Diabetol. 2008;51:1947-53.

Francque SM, van der Graaff D, Kwanten WJ. Non-alcoholic fatty liver disease and cardiovascular risk: Pathophysiological mechanisms and implications. J Hepatol. 2016; 65:425-43.

S Banerjee, US Ghosh, S Dutta. Clinicopathological profile of hepatic involvement in type-2 diabetes mellitus and its significance. JAPI. 2008;56.

Sung KC, Ryan MC, Wilson AM. The severity of nonalcoholic fatty liver disease is associated with increased cardiovascular risk in a large cohort of non-obese Asian subjects. Atherosclero. 2009 Apr 1;203(2):581-6.

Targher G, Arcaro G. Non-alcoholic fatty liver disease and increased risk of cardiovascular disease. Atherosclero. 2007;191:235-40.

Bluemke DA, Kronmal RA, Lima JA, Liu K, Olson J, Burke GL, et al. The relationship of left ventricular mass and geometry to incident cardiovascular events: the MESA (Multi-Ethnic Study of Atherosclerosis) study. J Am Coll Cardiol. 2008;52:2148-55.

Downloads

Published

2018-07-23

Issue

Section

Original Research Articles