Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 27, 2024; 16(8): 1120-1130
Published online Aug 27, 2024. doi: 10.4254/wjh.v16.i8.1120
Correlation between non-alcoholic fatty liver disease and metabolic parameters in persons with newly diagnosed type 2 diabetes mellitus
Supriyo Mukherjee, Sushmita Mukherjee, Chun Shing Kwok, Anne Phillips
Supriyo Mukherjee, Department of Medicine, Research Centre for Diabetes Hypertension and Obesity, Samastipur 848101, India
Sushmita Mukherjee, Department of Clinical Ultrasonography, Research Centre for Diabetes Hypertension and Obesity, Samastipur 848101, India
Chun Shing Kwok, Cardiology Registrar, University Hospitals of North Midlands NHS Trust United Kingdom, Staffordshire ST4 6QG, United Kingdom
Anne Phillips, Faculty of Health Education and Life Sciences, Department of Post-Qualifying Healthcare Practice, Birmingham City University, Birmingham B4 7AP, United Kingdom
Author contributions: Mukherjee S and Mukherjee S conceptualized the study and performed the data curation and analysis; Kwok CS and Phillips A contributed to the study methodology and interim manuscript review. All authors reviewed and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Gurushree Hi-Tech Multispecialty Hospital Ethics Committee (No. 8/22/004IEC) and the Faculty Academic Ethics Committee in the Health, Education and Life Sciences at Birmingham City University (Mukherjee/#10953/sub2/R(C)/2022/Nov/HELS FAEC).
Informed consent statement: As this study falls under the category of epidemiological research and involves the analysis of existing data without direct patient contact or intervention, the need for obtaining informed consent from individual participants was deemed unnecessary. Therefore, no informed consent form was utilized in this study.
Conflict-of-interest statement: The authors declare that they each have no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Supriyo Mukherjee, MD, Doctor, Department of Medicine, Research Centre for Diabetes Hypertension and Obesity, Bengali Tola, Bihar, Samastipur 848101, India. supriyorcdho@outlook.com
Received: January 4, 2024
Revised: June 6, 2024
Accepted: July 17, 2024
Published online: August 27, 2024
Processing time: 230 Days and 10.3 Hours
Abstract
BACKGROUND

There are limited studies investigating the association between type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) in the region of Bihar, India.

AIM

To estimate the prevalence of NAFLD in persons with newly diagnosed T2DM in the population of North Bihar, India.

METHODS

This single centre cross-sectional study was undertaken in the Research Centre for Diabetes Hypertension and Obesity, Samastipur, Bihar, India. Data were collected from persons newly diagnosed with T2DM or those diagnosed within 6 months of when the study was conducted between December 2022 to May 2023.

RESULTS

A total of 148 people with newly diagnosed T2DM were included (median age 47 years, 46.6% female) and 109 patients with liver disease on ultrasound evaluation. The persons with liver disease consumed more fats and oils (88.1% vs 74.4%, P = 0.042) and they had significantly greater body mass index (27.4 vs 23.0, P < 0.001), waist circumference (37 vs 33, P < 0.001), and waist-to-hip ratio (1.00 vs 0.70, P = 0.025). Females were associated with greater liver disease [odds ratio (OR): 3.09, 95% confidence interval (CI): 1.09-8.80, P = 0.32]. Waist circumference (OR: 1.42, 95%CI: 1.22-1.66, P < 0.001) and low-density lipoprotein cholesterol (OR: 1.01, 95%CI: 1.01-1.02, P = 0.048) were associated with any liver disease. The factors most associated with grade 2/3 liver disease was right upper quadrant pain or heaviness (OR: 5.22, 95%CI: 1.40-19.41, P = 0.14), greater income (OR: 3.58, 95%CI: 1.28-10.04, P = 0.015) and waist circumference (OR: 1.31, 95%CI: 1.02-1.69, P = 0.036).

CONCLUSION

NAFLD is common in new/recently diagnosed T2DM and disease burden is high and common among patients who are either high consumers of fats and oils or have obesity-associated markers.

Keywords: Type 2 diabetes mellitus; Non-alcoholic fatty liver disease; Prevalence; Waist circumference; Obesity

Core Tip: This study evaluated the association between type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). Nearly 3 of 4 patients with T2DM had evidence of NAFLD. This study also concluded that NAFLD is common in patients who consume high amounts of fats and oils. A higher percentage of females were diagnosed with NAFLD and exhibited higher body mass index, waist circumference and lipid levels. Serum alanine aminotransferase levels have potential as a screening tool, aligning with recommendations for universal screening in T2DM populations. Early identification of NAFLD in T2DM patients may enable interventions to mitigate disease progression.