NON ALCOHOLIC FATTY LIVER DISEASE AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS IN SULAIMANI GOVERNORATE 


Mohammed O. Mohammed a, Hemn Hadi b and Fenk B. Maarouf c



a Department of Medicine, College of Medicine, University of Sulaimani. 
b Directorate of Health of Sulaimani
c Department of Biochemistry, College of Medicine, University of Sulaimani. 

 
 
Submitted: 15/10/2016; Accepted: 1/10/2017; Published 21/12/2017


ABSTRACT


Background 

Nonalcoholic fatty liver disease (NAFLD) is a common hepatic disorder characterized by accumulation of fat in the liver parenchyma of patients who do not drink excessive amount of alcohol. The prevalence of NAFLD is high in conditions associated with insulin resistance, such as obesity, type 2 DM, dyslipidemia and the metabolic syndrome. NAFL is very common in type-2 diabetic patients, with 50-75% demonstrating fat in the liver by ultrasound.

Objectives
 
To assess the frequency of NAFLD in patients with type 2 DM in Sulaimani and its relation with age, gender, duration and state of glycaemic control compared to non diabetic subjects.

Methods

This is across sectional study, conducted in Sulaimani General Teaching Hospital from December. 2013 to December 2014. A total of 102 patients were enrolled in the study, sixty seven were diabetic and 35 were nondiabetic as control. Patients with chronic viral hepatitis B, C, autoimmune hepatitis, excessive alcohol ingestion, and drugs with adverse effect on liver were excluded. These patients were evaluated by abdominal ultrasonography to determine the presence of fatty liver. They were divided into fatty liver group and non-fatty liver group. They were further evaluated for BMI, waist/hip ratio, blood pressure, lipid profile, liver function test. The data obtained was analyzed using SPSS-21.

Results

61% of diabetic patients had fatty liver on ultrasonography; of those 17% fulfill the criteria of NASH, compared to 48%, 6% in the control group respetively. BMI, serum triglyceride and ALT were significantly higher in group with fatty liver than non fatty liver in both diabetic and control (P-value= 0.001, 0.027, and 0.006 respectively).The frequency of NAFLD increases with age. Diabetes was associated with more severe degree of NAFL and fibrosis score. 

Conclusion

NAFLD is more common in type 2 DM than nondiabetic. Obesity, hypertriglyceridemia, and HbA1c are independent predictors of NAFLD.

KEYWORDS

Type 2 DM, NAFLD, NASH, Obesity, Sulaimani.