Objectives:Non alcoholic fatty liver disease (NAFLD) is commonly associated with type 2 diabetes mellitus (DM) though its prevalence is not well studied. We conducted a prospective tudy of risk factors of NAFLD in patientswith type 2 diabetes. The liver, once fatty, is nsulin resistant and overproduces both glucose and VLDL leading to hyperglycaemia, hypertriglyceridemia, and a low HDL cholesterol concentration. Methods: Type 2 DM atients attending the out-patient diabetic clinic underwent abdominal ultrasonography. 50 patients were selected for the study.Patients with fatty infiltration on ultrasound consented for clinical and biochemical workup.
Results: The Patients with NAFLD were more obese, had a higher waist circumference and serum triglyceride and alanine aminotransferase (ALT) levels than those without steatosis. Neither diabetic degenerative complication, nor glycaemic control was associated with liver steatosis. On multivariate analysis, a high serum triglycerides level and a high-normal ALT level (≥40 U/L) were independently associated with hepatic steatosis, together with either the presence of obesity or of increased waist circumference.Abdominal Ultrasound showed fatty liver changes in 40 patients (55.6%), 27 of them (67.5%) were obese. Serum HDL cholesterol levels were significantly lower in patients with NAFLD
Conclusions: Prevalence of NAFLD and NASH in our cohort of type 2 DM patients is high and increases with multiple components of metabolic syndrome. NASH and dvanced fibrosis can occur in diabetic patients without any symptoms, signs or routine laboratory test abnormalities. Type-2 diabetic patients have a high prevalence of ultrasonographic NAFLD and its presence is associated with obesity, mainly abdominal, hyper triglyceridaemia and highnormal ALT levels. Nonalcoholic fatty liver disease in diabetic patients may develop and progress independent of the diabetes progression itself.