Prevalence of non-alcoholic fatty liver disease in type 2 diabetes mellitus patients in a tertiary care hospital of Bihar

Background: Macrovesicular fat accumulation in more than 5% of hepatocytes without significant alcohol consumption is the defining criteria of Non-alcoholic fatty liver disease (NAFLD). Non-alcoholic fatty liver disease is often associated with diabetes mellitus which is associated with a 60-70% of frequency of Non-alcoholic fatty liver disease. The prevalence of NAFLD among the Type 2 Diabetes mellitus (T2DM) patients is higher compared to non-diabetics. Type 2 Diabetes mellitus and Non-alcoholic fatty liver disease are common conditions that commonly co-exist and can act reciprocally to bring adverse outcomes. Aim and objectives: The aim of this study was framed to determine the prevalence of Non-alcoholic fatty liver disease in Type 2 Diabetes mellitus patients and also to study the risk factors. Material and methods: The present cross sectional, prospective study was conducted at Indira Gandhi Institute of Medical Sciences, Patna, a tertiary care hospital of Bihar, over a period of 5 months. A total of 140 patients with Type 2 Diabetes mellitus that satisfied inclusion criteria were included in the study. All patients included in the study were subjected to ultrasonography and relevant history, thorough clinical examinations and biochemical tests were performed and recorded. Results: Out of 140 patients participated in the study, 44 (31.43%) were found to have Non-alcoholic fatty liver disease (NAFLD). The most common ultrasonographic grade of NAFLD was grade I (mild) fatty liver disease 30(21.43%), followed by grade II (moderate) fatty liver disease 13 (9.29%). The grade III (severe) fatty liver disease was found in 1 (0.71%) of the diabetic patients. NAFLD patients were compared with those with normal liver ultrasonographic findings. The risk factors of NAFLD were also evaluated. The highest prevalence of NAFLD was recorded in the age group of 51-60 years and it was more prevalent among females than males. Conclusion: An observation into the predisposing factors of Non-alcoholic fatty liver disease, revealed a higher prevalence of obesity, hypertension, hyperlipidemia, hyperglycemia and sedentary lifestyle in the subjects with NAFLD. Type 2 Diabetes mellitus patients having non-alcoholic fatty liver disease are at increased risk of developing progressive forms of the disease. The liver disorder constitutes another potential complication in T2DM patients that requires early and prompt intervention in the associated risk factors and prevents the emergence of chronicity of NAFLD.