Prevalence of Nonalcoholic Fatty liver Disease (NAFLD) and its association with Cardio-metabolic risk factors in Type 2 Diabetes Mellitus
Keywords:NAFLD, Diabetes, CAD
Backgroun: Type 2 diabetes mellitus (T2DM) and Nonalcoholic fatty liver disease (NAFLD) have risen globally to epidemic proportions. The study was aimed to determine the prevalence of NAFLD and its association with cardio-metabolic risk factors in T2DM subjects. Method: In a case control study, 212 consecutive, T2DM subjects with age ≥ 30 years, were evaluated from December 2017 to December 2018 at Mahatma Gandhi Medical College &Hospital, Jaipur, Rajasthan. Subjects with history of significant alcohol consumption, evidence of cirrhosis, hepatotoxic drugs, and other known causes of fatty liver were excluded. The T2DM subjects were divided into (1) NAFLD - patients with USG evidence of fatty changes in the liver (2) Non-NAFLD – patients without any USG evidence of fatty changes in the liver. Coronary artery disease was screened by any past medical history of CAD or electrocardiographic or angiography evaluation. Continuous variables were expressed as mean with standard deviation. Comparison of continuous data between subgroups was done by using Independent student’s t-test or Mann Whitney U test. All statistical analysis was carried out by SPSS version 25. Result:55.66% diabetics had comorbid NAFLD. Both study groups had comparable mean age (p 0.719) and gender distribution (p 0.482). Subjects with NAFLD had significantly higher BMI (p 0.0001), mean waist circumference (p <0.001), waist hip ratio (p <0.001), systolic BP (p 0.001), diastolic BP (p 0.024), HbA1c (p 0.021), total cholesterol (p 0.0426) & triglyceride (p 0.02). Mean LDL (p 0.054), VLDL (p 0.235) & HDL (p 0.113) values were comparable in two study groups, suggesting no significant association with NAFLD. 32 (15.09%) subjects had coronary artery disease (CAD). Diabetics with NAFLD had significantly higher CAD (22.03% vs 9.57%, p 0.02).Conclusion: Diabetics with NAFLD had significantly higher cardio-metabolic risk factors, leading to increased associated risk of CAD.
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