Euroasian journal of hepato-gastroenterology

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VOLUME 9 , ISSUE 1 ( January-June, 2019 ) > List of Articles

Original Article

Nonalcoholic Fatty Liver Diseases among Recently Diagnosed Patients with Diabetes Mellitus and Risk Factors

Amna Subhan Butt, Saeed Hamid, Zishan Haider, Fatima Sharif, Mohammad Salih, Safia Awan, Aatif A Khan, Jaweed Akhter

Keywords : Diabetes mellitus, Nonalcoholic fatty liver disease, Risk factors, Prevalence

Citation Information : Subhan Butt A, Hamid S, Haider Z, Sharif F, Salih M, Awan S, Khan AA, Akhter J. Nonalcoholic Fatty Liver Diseases among Recently Diagnosed Patients with Diabetes Mellitus and Risk Factors. Euroasian J Hepatogastroenterol 2019; 9 (1):9-13.

DOI: 10.5005/jp-journals-10018-1288

License: CC BY-NC 4.0

Published Online: 01-09-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim: Prevalence of obesity and type 2 diabetes mellitus (T2DM), both of which represent are related to nonalcoholic fatty liver disease (NAFLD), is an increasing trend among Asian people. The study aimed to assess the prevalence of NAFLD in T2DM with their risk factors in the Southern part of Pakistan. Materials and methods: A cross-sectional study was accomplished during 2008–2013 at The Aga Khan University Hospital, Karachi, Pakistan. Adult patients diagnosed with T2DM during last 6 months were enrolled in this study. NAFLD was identified using ultrasound of the liver. Clinical and biochemical relevant measurements were accomplished. Results: Out of a total of 203 patients with T2DM, NAFLD was detected in 146 patients (71.9%). Multivariate analysis revealed that NAFLD was significantly associated with dyslipidemia (OR 2.38, 95% CI 1.06–5.34, p = 0.035), higher LDL (OR 1.02, 95%CI 1.01–1.03, p = 0.003), HbA1c (OR1.27, 95% CI 0.97–1.68, p = 0.045) and diastolic blood pressure (OR 1.05, 95% CI 1.01–1.10, p = 0.009). The highest odds of 10.8 for NAFLD (95% CI 4.9–24, p = 0.001) was found for the combination of hypertension, dyslipidemia, body mass index (BMI), waist circumference, lack of physical inactivity, triglycerides, lower HDL, LDL, HbA1c, and ALT (multiplicative analysis). Conclusion: High incidence of NAFLD with the association of different lifestyle-related factors has been analyzed. It unmasks the need for screening for NAFLD in newly diagnosed DM patients in Pakistan with the assessment of parameters of risk factors.


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  1. Younossi ZM, Stepanova M, et al. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol 2011;9(6):524-530. e1.
  2. Chalasani N, Younossi Z, et al. The diagnosis and management of non alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology 2012;55(6):2005-2023.
  3. Baffy Gr, Brunt EM, et al. Hepatocellular carcinoma in non-alcoholic fatty liver disease: an emerging menace. J Hepatol. 2012;56(6):1384- 1391.
  4. Ashtari S, Pourhoseingholi MA, et al. Non-alcohol fatty liver disease in Asia: Prevention and planning. World J Hepatol 2015;7(13):1788.
  5. Fan JG, Zhu J, et al. Prevalence of and risk factors for fatty liver in a general population of Shanghai, China J Hepatol 2005;43(3):508-514.
  6. Clark JM, Diehl AM. Nonalcoholic fatty liver disease: an underrecognized cause of cryptogenic cirrhosis. JAMA 2003;289(22):3000-3004.
  7. Dasarathy S, Dasarathy J, et al. Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study. J Hepatol 2009;51(6):1061-1067.
  8. Hassan K, Bhalla V, et al. Nonalcoholic fatty liver disease: A comprehensive review of a growing epidemic. World J Gastroenterol 2014;20(34):12082.
  9. Bhat G, Baba CS, et al. Insulin resistance and metabolic syndrome in nonobese Indian patients with non-alcoholic fatty liver disease. Trop Gastroenterol 2013;34(1):18-24.
  10. Targher G, Bertolini 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):1212-1218.
  11. Younossi ZM, Gramlich T, et al. Nonalcoholic fatty liver disease in patients with type 2 diabetes. Clin Gastroenterol Hepatol 2004;2(3):262-265.
  12. Shaw JE, Sicree RA, et al. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 87(1):4-14.
  13. Yoon K-H, Lee J-H, et al. Epidemic obesity and type 2 diabetes in Asia. The Lancet 2006;368(9548):1681-1688.
  14. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet (London, England) 2004;363(9403):157-163.
  15. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15(7):539-553.
  16. Chobanian AV, Bakris GL, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289(19):2560-2572.
  17. Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech 2009;2(5-6):231-237.
  18. Fan JG, Saibara T, et al. What are the risk factors and settings for nonalcoholic fatty liver disease in Asia-Pacific? J Gastroenterol Hepatol 2007;22(6):794-800.
  19. Joseph AEA, Saverymuttu SH, et al. Comparison of liver histology with ultrasonography in assessing diffuse parenchymal liver disease. Clin Radiol 1991;43(1):26-31.
  20. EPI Info: a word processing database and statistics program for public health [computer program]. Version 6. Atlanta GCfDCaP, 1995.
  21. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002; 346(16): 1221-1231.
  22. Kasturiratne A, Weerasinghe S, et al. Influence of non alcoholic fatty liver disease on the development of diabetes mellitus. J Gastroenterol Hepatol 2013;28(1):142-147.
  23. Farrell GC, Wong VW, et al. NAFLD in Asia--as common and important as in the West. Nat Rev Gastroenterol Hepatol 2013;10(5):307-318.
  24. Amarapurkar DN, Hashimoto E, et al. How common is non-alcoholic fatty liver disease in the Asia-Pacific region and are there local differences? J Gastroenterol Hepatol 2007;22(6):788-793.
  25. Farrell GC. Non-alcoholic steatohepatitis: what is it, and why is it important in the Asia-Pacific region? J Gastroenterol Hepatol 2003;18(2):124-138.
  26. de Moura Almeida A, Cotrim HP, et al. Fatty liver disease in severe obese patients: diagnostic value of abdominal ultrasound. World J Gastroenterol 2008;14(9):1415.
  27. Perez NE, Siddiqui FA, et al. Ultrasound diagnosis of fatty liver in patients with chronic liver disease: a retrospective observational study. J Clin Gastroenterol 2007;41(6):624-629.
  28. Nascimbeni F, Pais R, et al. From NAFLD in clinical practice to answers from guidelines. J Hepatol. 2013;59(4):859-871.
  29. Kalra S, Vithalani M, et al. Study of prevalence of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes patients in India (SPRINT). J Assoc Physicians India 2013;61(7):448-453.
  30. Fan J-G, Zhu J, et al. Prevalence of and risk factors for fatty liver in a general population of Shanghai, China. J Hepatol 2005;43(3):508-514.
  31. Aller R, Izaola O, et al. Predictive factors of non-alcoholic steatohepatitis: relationship with metabolic syndrome. Nutricion Hospitalaria 2015;31(6):2496-2502.
  32. Fraser A, Harris R, et al. Alanine aminotransferase, γ-glutamyltransferase, and incident diabetes The British Women's Heart and Health Study and meta-analysis. Diabetes Care 2009;32(4):741-750.
  33. Krishnan AVJ. Prevalence of nonalcoholic fatty liver disease and its biochemical predictors in patients with type-2 diabetic mellitus. E&C Hepatology 2011;7(3-4):7-10.
  34. Dassanayake AS, Kasturiratne A, et al. Prevalence and risk factors for non-alcoholic fatty liver disease among adults in an urban Sri Lankan population. J Gastroenterol Hepatol 2009;24(7):1284-1288.
  35. Ueno T, Sugawara H, et al. Therapeutic effects of restricted diet and exercise in obese patients with fatty liver. J Hepatol 1997;27(1): 103-107.
  36. Suzuki A, Lindor K, et al. Effect of changes on body weight and lifestyle in nonalcoholic fatty liver disease. J Hepatol 2005;43(6):1060-1066.
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