Study of association of non alcoholic fatty liver disease (NAFLD) with micro and macrovascular complications of type 2 diabetes mellitus (T2DM)

Ashutosh M. Somalwar, Arshish D. Raut


Background: Non Alcoholic Fatty Liver Disease (NAFLD) is a common liver disorder that is strongly associated with insulin resistance and Type 2 Diabetes Mellitus (T2DM). This study was designed to determine the prevalence of NAFLD among T2DM patients and to evaluate whether there is an association between NAFLD and diabetic micro-and macro vascular complications.

Methods: In a cross-sectional design study, 120 type 2 diabetic patients were submitted to a complete clinical and laboratory evaluation and abdominal ultrasonography for NAFLD detection and grading. They were divided into fatty liver group and non-fatty liver group and various laboratory and clinical variables were compared in these two groups. Statistical analysis included bivariate tests, chi square test, univariate and multivariate logistic regression.

Results: Out of 120 type 2 diabetic patients, 68 (56.66%) had fatty liver on ultrasonography. An increase in the waist circumference, BMI, systolic blood pressure, diastolic blood pressure and levels of HBA1c, AST, ALT, Total Cholesterol, Triglycerides and a decrease in HDL was observed in the fatty liver group as compared to non-fatty liver group. NAFLD group had higher prevalence of retinopathy (67.67% vs. 17.30%, P <0.001), neuropathy (52.94% vs. 19.23%, P = 0.0002), nephropathy (83.82% vs.53.84%, P = 0.0003). The prevalence of CAD (70.58% vs. 21.11%, P <0.0001) and POVD (10.25% vs. 0%, P <0.05) was higher in NAFLD patients. All patients with severe fibrosis had raised BMI, HbA1c and hypertension. The results of multiple logistic regression analysis showed that NAFLD was associated with BMI, HbA1c, Triglyceride and CAD. Univariate analysis showed significant association between retinopathy, neuropathy, CAD, POVD and NAFLD.

Conclusion: Cognitive. The prevalence of NAFLD is higher in type 2 diabetic patients. Obesity, dysglycemia, dyslipidemia, elevated liver enzymes and coronary artery disease are seen to be significantly associated with fatty liver than non-fatty liver type 2 diabetic patients.



Type 2 diabetes mellitus, NAFLD, Micro and macro vascular complications

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