TYPE 2 DIABETES

NON ALCOHOLIC FATTY LIVER DISEASE (NAFLD)

Abstract

Objectives: To determine the prevalence and the associated risk factors of
NAFLD in Type 2 diabetic patients. Study Design: Cross sectional study. Setting: Diabetic
clinic of Medical Unit 3, JPMC. Methods: It is a cross sectional study. 262 patients were
enrolled between the ages of 18-70 years attending Diabetes Clinic of Medical Unit III, JPMC.
Each consenting patient underwent a detailed medical history-taking, physical examination,
laboratory assessment and abdominal ultrasonography (US). Fatty liver was diagnosed on
abdominal US on the basis of two out of the three criteria: increased hepatic echogenicity,
blurring of liver vasculature and deep attenuation of the ultrasonographic signal. In accordance
with the guidelines, subjects diagnosed with NAFLD had to fulfill the following criteria: no
history of current or past alcohol consumption, other systemic illness known to cause fatty liver
disease; absence of history and clinical, biochemical and US findings consistent with cirrhosis.
Body mass index (BMI) was calculated. Blood pressures of greater than 130/90 were taken
as hypertensive. LFTs, FBS, HbA1c, Lipid profiles were taken. Results: Out of 262 diabetic
patients 107 (40.8%) of them were found to be having NFALD. Prevalence was found out to be
higher in age group of 41-50 years, females, obese & in Pashtoon subjects.It was also more
prevalent in sedentary lifestyle patients and those on oral anti diabetics in contrast to insulin
therapy. It was correlating well with US findings when the ALT cut-off value was taken as 30 IU
for males and 19 IU for females compared to standard values of ALT. There was association
with hypertension, metabolic syndrome and dyslipidemia. Conclusion: Prevalence of NAFLD
was higher in our diabetic patients. Middle age, female gender and obesity were found to be
statistically strong risk factors in our study.