A Study of Non-Alcoholic Fatty Liver Disease (NAFLD) in Type 2 Diabetes Mellitus in a Tertiary Care Centre, Southern India 243-245
Dr. Jayarama N., Assistant Professor,
Department of General Medicine, Sri Devraj URS Medical College,
Tamaka, Kolar - 563101, Karnataka, India.
Background: Type 2 diabetes mellitus is a common disease. The spectrum of liver diseases which ranges from innocuous enzyme elevation to progressive chronic liver disease has been described in association with type -2 diabetes mellitus. Mild chronic elevations of transaminases often reflect the underlying insulin resistance. NAFLD is a liver condition that is being recognized with an increasing frequency and it may progress to end stage liver disease.
Aims: To study the Non-Alcoholic Fatty Liver Disease in type 2 diabetic patients and the correlation between glycaemic control (FBS) and the duration of diabetes with respect to the ALT levels.
Study Design: A randomized case control study
Materials and Methods: Fifty type 2 diabetics and fifty non diabetics who were taken as age, sex and body mass index (BMI) matched controls were studied. Subjects with a history of icterus, alcohol consumption and HBsAg positivity were excluded from the study. NAFLD was diagnosed if â€śfatty liverâ€ť was found on ultrasonography (USG). Fasting blood sugar (FBS), post parindal blood sugar (PPBS) and liver function test (LFT) were done. The results were compared by using suitable statistical methods. (Studentâ€™s unpaired â€śtâ€ť-test and Pearsonâ€™s correlation co-efficient).
Results: NAFLD was noted in 60% of the cases and in 20% of the controls. A body mass index of > 25kg/m2 was significantly associated with NAFLD in both the cases and the controls. The duration of diabetes was significantly associated with NAFLD (p = 0.0054). A significant relationship was found between the presence of NAFLD and the female sex in the cases (p=0.0392), but not in the controls (p = 0.2790). The levels of alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were significantly high in the cases as compared to those in the controls. There was a positive co-relation between FBS, PPBS and the duration of diabetes with respect to the ALT levels.
Conclusion: Non-alcoholic fatty liver disease (NAFLD), as determined by ultrasound, is common in type 2 diabetics. There is a positive correlation between FBS (Fasting blood sugar), PPBS (post prandial blood sugar), and the duration of diabetes with respect to the ALT levels.