Publication:

Study of prevalence of non alcoholic fatty liver disease in type 2 diabetes mellitus patients and variations in liver function tests, lipid profile and mean platelet volume in patients with fatty liver in comparison with patients without fatty liver

Background Type 2 diabetes mellitus (T2DM) patients potentially are at risk of developing non-alcoholic fatty liver disease. The aim of the study is to determine the prevalence of NAFLD among T2DM patients, diagnosed by ultrasonography of liver, to study the age & sex incidence of NAFLD and to compare the liver function tests, lipid profile and mean platelet volume (MPV) between individuals with NAFLD and without NAFLD.

Methods Total of 97 type 2 diabetes mellitus ambulatory patients were selected for the study. Among them 62 were males (63.9%) and 35 were females (36%). 78 healthy subjects were selected as controls. Their age ranged between 27 to 75 years. Serum was used for the estimation of FBS, PPBS, total bilirubin, direct bilirubin, AST, ALT, ALP, GGT, total protein, albumin, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). EDTA blood was used for the estimation of MPV. Fatty liver was diagnosed on ultrasound based on the echogenicity and size of the liver.

Results In this study, liver size & echotexture, liver enzymes such as AST, ALT, ALP and GGT, serum cholesterol, TGL and LDLC were found to be statistically significantly increased in T2DM patients when compared to controls. T2DM patients were divided in to two groups; group 1 included patients with NAFLD and group 2 included patients without NAFLD. Liver size, AST, ALT, ALP, GGT, Cholesterol and TGL were significantly increased in group 1 patients when compared to group 2 patients (P value<0.05). Elevation of MPV was found to be more in group 1 patients than group 2 patients ranging between 12.1±3.0 and 10.2±0.9 respectively.

Conclusions Early detection and optimum control of diabetes mellitus is important to minimize the effect of diabetes on liver. Hence, assay of serum levels of hepatic enzymes and USG abdomen to detect NAFLD should be done in all patients with T2DM as preliminary diagnostic tests.