A study of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus and its correlation with cardiovascular risk
DOI:
https://doi.org/10.18203/2349-3933.ijam20221093Keywords:
Non-alcoholic fatty liver disease, NAFL, Non-alcoholic steatohepatitisAbstract
Background: NAFLD (non-alcoholic fatty liver disease) encompasses a variety of disorders of lipid metabolism ranging from NAFL, NASH to cirrhosis and rarely HCC. A great deal of evidence suggests that the metabolic syndrome predicts incident cardiovascular disease (CVD), so it is possible to hypothesize that NAFLD patients might portend a greater CVD risk and that NAFLD itself might confer a CVD risk above that associated with individual metabolic syndrome risk factors.
Methods: 55 T2DM patients were included in current study conducted from August 2019 to September 2021 for assessment of NAFLD using USG abdomen, NAFLD fibrosis score and FIBROSCAN. ASCVD score was used for correlation between CVD risk and NAFLD.
Results: Out of 55 patients 42 (76.4%) were having fatty liver based on USG abdomen while 13 (23.4%) patients were having no fatty liver. As far as steatosis is concerned mean CAP (dB/m) was 245±50.89 out of which 24 (43.6%) were having no or minimal steatosis (S0), while 31 (56.4%) were having significant steatosis with 11 (20%), 9 (16.4%) and 11 (20%) having S1, S2 and S3 grade of steatosis respectively. 15 patients out of 55 were of F0 grade while 19 (34.5%), 9 (16.4%), 7 (12.7%) and 5 (9.1%) were of grade F1, F2, F3 and F4 respectively. There was a positive statistically significant (p≤0.001) association of ASCVD risk score with NAFLD fibrosis score and fibroscan: E (KPa).
Conclusions: Our study found that the prevalence of NAFLD was quite higher in patients with T2DM based on both USG abdomen (76.4%) and transient elastography (steatosis-56.4% and fibrosis-65.5%) and a statistically significant association between fibrosis and ASCVD score with higher fibrosis associated with higher 10 years ASCVD score.
References
Dharmalingam M, Yamasandhi PG. Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus. Indian J Endocrinol Metab. 2018;22(3):421-8.
Targher G, Bertolini L, Padovani R, Rodella S, Tessari R, Zenari L, et al. Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diabetes Care. 2007;30(5):112-8.
Angulo P: Nonalcoholic fatty liver disease. N Engl J Med. 2002;346:1221-31.
Day CP: Non-alcoholic fatty liver disease: current concepts and management strategies. Clin Med. 2006; 6:19-25.
McCullough AJ. Pathophysiology of nonalcoholic steatohepatitis. J Clin Gastroenterol. 2006;40(1):S17-29.
Marchesini G, Marzocchi R, Agostini F, Bugianesi E. Nonalcoholic fatty liver disease and the metabolic syndrome. Curr Opin Lipidol. 2005;16:421-7.
Clark JM, Brancati FL, Diehl AM. The prevalence and aetiology of elevated aminotransferase levels in the United States. Am J Gastroenterol. 2003;98:960-7.
Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G, Bellentani S: Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos Nutrition and Liver Study. Hepatol. 2005;42: 44-52.
Browning JD, Szczepaniak LS, Dobbins R, Nuremberg P, Horton JD, Cohen JC, Grundy SM, Hobbs HH. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatol. 2004;40:1387-95.
Caussy C, Aubin A, Loomba R. The relationship between type 2 diabetes, nafld, and cardiovascular risk. Curr Diab Rep. 2021;21(5):15.
Younossi ZM, Golabi P, de Avila L, Paik JM, Srishord M, Fukui N, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis. J Hepatol. 2019; 71(4):793-801.
Doycheva I, Cui J, Nguyen P, Costa EA, Hooker J, Hofflich H, et al. Non-invasive screening of diabetics in primary care for NAFLD and advanced fibrosis by MRI and MRE. Aliment Pharmacol Ther. 2016;43(1): 83-95.
