Prevalence and Risk Factors of Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus

Abstract

Background:

Non-alcoholic fatty liver disease is a frequent hepatic complication of type 2 diabetes mellitus and may progress, silently, to clinically important fibrosis.

Aim

The aim of this study was to determine the prevalence of non-alcoholic fatty liver disease among patients with type 2 diabetes mellitus and to evaluate the associated metabolic and clinical risk factors.

Materials and Methods :

This cross-sectional observational study was conducted in a tertiary healthcare setting. Adults underwent abdominal ultrasonography to diagnose hepatic steatosis; vibration-controlled transient. elastography was performed in selected cases to assess steatosis and fibrosis staging. The cohort included 200 participants: 100 with type 2 diabetes mellitus and 100 controls. Multivariable logistic regression was used to identify independent predictors.

Results:

Non-alcoholic fatty liver disease was present in 73.0% of the type 2 diabetes mellitus group versus 8.0% of controls (probability value < 0.001). In the type 2 diabetes mellitus group, steatosis staging was 27.0% (S0), 16.0% (S1), 31.0% (S2), and 26.0% (S3), and fibrosis staging was 45.0% (F0), 30.0% (F1), 14.0% (F2), 6.0% (F3), and 5.0% (F4) (probability value < 0.001). Type 2 diabetes mellitus was independently associated with higher odds of non-alcoholic fatty liver disease (adjusted odds ratio 7.53; 95% confidence interval 2.40–23.62; probability value < 0.001). Body mass index was significant (adjusted odds ratio 1.14 per 1 kilogram per square meter; 95% confidence interval 1.04–1.25; probability value = 0.007), while high-density lipoprotein cholesterol showed an inverse association (adjusted odds ratio 0.93 per 1 milligram per deciliter; 95% confidence interval 0.88–0.98; probability value = 0.011).

Conclusion:

Non-alcoholic fatty liver disease was highly prevalent among patients with type 2 diabetes mellitus and was independently associated with diabetes status and adiposity, while higher high-density lipoprotein cholesterol was protective.