“TO EVALUATE THE ASSOCIATION BETWEEN NAFLD/NASH IN PREDIABETES AND TYPE 2 DIABETES MELLITUS WITH NON-INVASIVE BIOMARKERS.”

Abstract

Hepatic steatosis, or the buildup of extra fat in the liver, is a hallmark of nonalcoholic fatty liver disease (NAFLD), a group of liver disorders that affect people who drink little or no alcohol. Metabolic risk factors like obesity, insulin resistance, type 2 diabetes, and dyslipidemia are frequently linked to it. NAFLD is usually diagnosed when fat accumulation is <5% in hepatocytes. In addition to fat accumulation, NASH, the more serious kind of NAFLD, additionally comprises injury to hepatocytes and liver inflammation, with or without fibrosis. Hepatocellular carcinoma, cirrhosis, and severe fibrosis can develop from NASH. The World Health Organization (WHO) estimates that 642 million adults worldwide will have diabetes mellitus (DM) by 2040, rising from the 422 million adults who had it in 2014.T2DM is a substantial contributor to morbidity and mortality and places a heavy financial strain on the healthcare systems of the world . It is characterized by a combination of inherited and environmental factors that results in relative insulin insufficiency and insulin resistance. NAFLD AND T2DM both are highly prevalent disease worldwide. According to research both have a strong relation .there are many studies that proven the relation between them globally, nonetheless, there are still discrepancies in research and clinical awareness, particularly in low- and middle-income countries, like Pakistan. We aim to detect the prevalence of NAFLD or NASH in T2DM and pre-diabetic patients. The study was conducted in NMC hospital located in Karachi, Pakistan. The patients were enrolled from the diabetic clinic, after consent was taken , questionnaire was filled with vitals and anthropometric measurement was taken ,the patient then send for blood sampling followed by ultrasound abdomen. According to our study we found that Prevalence of non-alcoholic fatty liver disease was 17.9% and 82.1% among pre-diabetes and diabetes patients respectively whereas prevalence of Non alcoholic steatohepatitis was 0% and 100% among pre-diabetes and diabetes patients respectively. We found significant association of non-alcoholic steatohepatitis with age group. Additionally, We found significant difference for age (p<0.001), LDL (p=0.006), ALT (p<0.001), AST (p<0.001) and ALT/AST ratio (p<0.001) according to non alcoholic fatty liver disease.