Abstract

Background: The prevalence of diabetes mellitus is increasing world over and is expected to affect 57 million adults in India by 2025. Apart from kidney, eye, heart and blood vessels, liver is also indirectly related with diabetes mellitus. Virtually the entire spectrum of liver disease is seen in patients with type 2 diabetes. This includes abnormal liver enzymes, non-alcoholic fatty liver disease (NAFLD), cirrhosis and acute liver failure. There are not enough studies from rural population done on the hepatic status of diabetic patients in our country. Hence this study aims to describe the hepatic profile of type 2 diabetic patients.
Materials & Methods: This is a prospective observational study where patients of diabetes mellitus with NAFLD diagnosed by USG were recruited. History and physical examination were recorded. Laboratory investigations included fasting and 2-hour post-prandial blood glucose, blood urea, serum creatinine, liver function tests, lipid profile, glycated hemoglobin were done. NAFLD was diagnosed on the basis of ultrasound assessment of the liver.
Results: We studied 200 NAFLD patients in type 2 DM, Most of the study subjects were asymptomatic and hepatomegaly was major physical sign observed we found that poor control of diabetes (p value: 0.0001) and duration of diabetes has adverse effect on NAFLD. Severity of NAFLD increases with poor control of diabetes. Obesity is a major risk factor for development of NAFLD. Waist/Hip ratio and BMI has an adverse effect on NAFLD. Dyslipidemia (75-80%) increases the incidence and severity of NAFLD. We found elevation of transaminase (57%) in our study. Metabolic syndrome (97%) is commonly associated with NAFLD.
Conclusion: Most patients were asymptomatic, Deranged transaminase and USG helps in early diagnosis of NAFLD. Obesity and dyslipidemia are major risk factors for development and progression of NAFLD. Poor glycemic control had increased incidence of NAFLD when compared to those with good glycemic control. Patients who were previously labelled as cryptogenic cirrhosis of liver are now increasingly diagnosed as having underlying NAFLD.