Manoria Piyush, Inamdar Sameer, Kumar Ravindra
Department of Gastroenterology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
Department of Medicine, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
J Family Med Prim Care. 2017 Jul-Sep;6(3):563-567. doi: 10.4103/2249-4863.222018.
Nonalcoholic fatty liver disease (NAFLD) and gallstones are frequently present in diabetics, but its exact prevalence is not well studied in India. We have done a prevalence study of hepatobiliary involvement in Type-2 diabetes mellitus (T2DM) and also studied the other risk factors of NAFLD.
Two hundred diabetics and 200 controls underwent anthropometric measurements, abdominal ultrasonography, (USG) and biochemical tests at a tertiary care hospital. Univariate and multivariate logistic regression analyses were done.
One hundred and thirty (65%) diabetics and 47 (23.50%) controls were having USG evidence of fatty liver (odds ratio [OR] = 6.046, 95% confidence interval [CI]: 3.904-9.363 [ < 0.0001]). Raised liver enzymes were present in 42 (21%) diabetics and 16 (8%) controls [OR = 3.057, 95% CI: 1.654-5.648 [ < 0.004]). Gallstones were present in 32 (16%) diabetics and 10 (5%) controls (OR = 2.825; 95% CI: 1.850-4.315 < 0.0001). In addition, waist circumference (WC) and body mass index (BMI) were significantly more in diabetics, but lipid profile was not significantly deranged as compared to controls. Then, all patients with fatty liver were compared with patients with normal liver, and we found that fatty liver group was having raised BMI, WC, liver enzymes, and more dyslipidemia. Multivariate analysis was done which shows the presence of T2DM, elevated liver enzymes, obesity, and elevated WC as independent risk factors of fatty liver.
The prevalence of NAFLD and gallstones was higher in diabetics as compared to healthy population. In addition, the presence of T2DM, elevated liver enzymes, obesity, and elevated WC are independent predictors of NAFLD.
非酒精性脂肪性肝病（NAFLD）和胆结石在糖尿病患者中很常见，但在印度其确切患病率尚未得到充分研究。我们对2型糖尿病（T2DM）患者的肝胆受累情况进行了患病率研究，并研究了NAFLD的其他危险因素。
在一家三级护理医院，对200名糖尿病患者和200名对照者进行了人体测量、腹部超声检查（USG）和生化检测。进行了单因素和多因素逻辑回归分析。
130名（65%）糖尿病患者和47名（23.50%）对照者有超声检查显示脂肪肝的证据（比值比[OR]=6.046，95%置信区间[CI]：3.904 - 9.363[<0.0001]）。42名（21%）糖尿病患者和16名（8%）对照者出现肝酶升高[OR = 3.057，95% CI：1.654 - 5.648[<0.004]）。32名（16%）糖尿病患者和10名（5%）对照者有胆结石（OR = 2.825；95% CI：1.850 - 4.315<0.0001）。此外，糖尿病患者的腰围（WC）和体重指数（BMI）明显更高，但与对照者相比，血脂谱没有明显紊乱。然后，将所有脂肪肝患者与肝脏正常的患者进行比较，我们发现脂肪肝组的BMI、WC、肝酶升高，且血脂异常更多。进行了多因素分析，结果显示T2DM、肝酶升高、肥胖和WC升高是脂肪肝的独立危险因素。
与健康人群相比，糖尿病患者中NAFLD和胆结石的患病率更高。此外，T2DM、肝酶升高、肥胖和WC升高是NAFLD 的独立预测因素。
