PREVALENCE OF NONALCOHOLIC - FATTY LIVER DISEASE IN METABOLIC SYNDROME - A HOSPITAL-BASED CROSS-SECTIONAL STUDY

Divya Kajaria

doi:10.22159/ajpcr.2017.v10i11.20159

Authors

Divya Kajaria Department of Kayachikitsa, All India Institute of Ayurveda, New Delhi, India

DOI:

https://doi.org/10.22159/ajpcr.2017.v10i11.20159

Keywords:

Hepatic steatosis, Dyslipidemia, Insulin resistance, Body mass index

Abstract

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Â Objective: 21st century is dedicated to noncommunicable diseases; it may be diabetes, hypertension, obesity, or constellation of all known as metabolic syndrome. The main objective of this paper is to assess the prevalence of nonalcoholic fatty liver disease (NFLDS) in metabolic syndrome and its impact on the severity of metabolic syndrome in term of dyslipidemia, mean systolic pressure and body mass index (BMI).

Methods: A cross-sectional study was conducted on 100 patients selected randomly during the period of January 2017-March 2017 from the outdoor patient department of Kayachikitsa of All India Institute of Ayurveda. Patient included on the basis of a screening pro forma based on the diagnostic criteria of metabolic syndrome on the basis of Third Adult Treatment Panel of the National Cholesterol Education Program criteria and 50 controls were included in the study. Pro forma also included general information regarding previous illness, socioeconomical status, BMI, evaluation of vital parameters, and lipid and thyroid profile, along with other routine laboratory parameters. Ultrasonography report is taken as the evidence for the diagnosis of fatty liver disease.

Results: Frequency distributions and Chi-square statistics were used for categorical variables. Logistic regression analyses Students' t-test, Chi-square test, linear regression, and multiple logistic regression models were used for statistical analysis. p<0.05 was considered significant. BMI, waist circumference, mean systolic pressure, diastolic blood pressure, fasting blood sugar, triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol were significantly higher, and high-density lipoprotein cholesterol, was significantly low in the study group compared to the control group. In the metabolic syndrome group, 67 patients (67%) had fatty liver Grade I, 34 had Grade II fatty liver (34%), 6 patients were having hepatomegaly with coarse echotexture (6%) and 4 patients were having cholelithiasis. NFLDS was significantly associated with metabolic syndrome group (p<0.0001). There was a significant linear association between fatty infiltration in liver and BMI, total cholesterol, triglycerides, and LDL cholesterol in the metabolic syndrome group in the linear regression model. Multiple logistic regression analysis recognized the association between fatty liver disease and BMI with dyslipidemia (p<0.001) in the metabolic syndrome group.

Conclusion: It is concluded from this study that there is a significant association between NFLDS and metabolic syndrome, and it highlights the importance of evaluating liver profile in patients with metabolic syndrome.

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References

Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech 2009;2(5-6):231-7.

Abd El-Kader SM, El-Den Ashmawy EM. Non-alcoholic fatty liver disease: The diagnosis and management. World J Hepatol 2015;7(6):846-58.

Ahmed HH, Salem AM, Mohamed MR, Shahat AA, Khalil WK, Mohamed SH. Experimental evidences for the promising therapeutic role of Vitis vinifera seed extract against non alcoholic steatohepatitis. Int J Pharm Pharm Sci 2015;7(2):417-24.

Khandelwal VK, Singh P, Ravingerova T, Chaudhary M. Evaluation of ezenus in an experimental model of diet-induced alcoholic and non-alcoholic fatty liver condition in rats. Int J Pharm Pharm Sci 2015;7(5):247-52.

Fabbrini E, Sullivan S, Klein S. Obesity and nonalcoholic fatty liver disease: Biochemical, metabolic, and clinical implications. Hepatology 2010;51(2):679-89.

Vuppalanchi R, Chalasani N. Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: Selected practical issues in their evaluation and management. Hepatology 2009;49(1):306-17.

Birkenfeld AL, Shulman GI. Non alcoholic fatty liver disease, hepatic insulin resistance and Type 2 diabetes. Hepatology 2014;59(2):713-23.

Paschos P, Paletas K. Non alcoholic fatty liver disease and metabolic syndrome. Hippokratia 2009;13(1): 9â€“19.

Sundaram SS, Zeitler P, Nadeau K. The Metabolic syndrome and non-alcoholic fatty liver disease in children. Curr Opin Pediatrics 2009;21(4):529-35.

Diehl AM. Fatty liver, hypertension and the metabolic syndrome. Gut 2004;53923-24.

Rahman M, Berenson AB. Accuracy of current body mass index obesity classification for white, black and Hispanic reproductive-age women. Obstet Gy necol 2010;115(5):982-8.

Aziz N, Kallur SD, Nirmalan PK. Implications of the revised consensus body mass indices for Asian Indians on clinical obstetric practice. J Clin Diagn Res 2014;8(5):OC01-3.

Portillo-Sanchez P, Bril F, Maximos M, Lomonaco R, Biernacki D, Orsak B, et al. High Prevalence of nonalcoholic fatty liver disease in patients with Type 2 diabetes mellitus and normal plasma aminotransferase levels. J Clin Endocrinol Metab 2015;100(6):2231-8.

Bhatt HB, Smith RJ. Fatty liver disease in diabetes mellitus. Hepatobiliary Surg Nutr 2015;4(2):101-8.

Duseja A, Singh SP, Saraswat VA, Acharya SK, Chawla YK, Chowdhury S, et al. Non-alcoholic fatty liver disease and metabolic syndrome-position paper of the Indian national association for the study of the liver, endocrine society of india, indian college of cardiology and Indian society of gastroenterology. J Clin Exp Hepatol 2015;5(1):51-68.

Diehl AM. Fatty liver, hypertension, and the metabolic syndrome. Gut 2004;53(7):923-4.

Zhang QQ, Lu LG. Nonalcoholic fatty liver disease: Dyslipidemia, risk for cardiovascular complications, and treatment strategy. J Clin Transl Hepatol 2015;3(1):78-84.

Sears B, Perry M. The role of fatty acids in insulin resistance. Lipids Health Dis 2015;14:121.