Herath Herath Mudiyanselage Meththananda, Kodikara Iroshani, Weerarathna Thilak Priyantha, Liyanage Gayani
Department of Medicine, Faculty of Medicine, PO Box 70, Galle, Sri Lanka.
Department of Anatomy, Faculty of Medicine, PO Box 70, Galle, Sri Lanka.
Diabetes Metab Syndr. 2019 Jan-Feb;13(1):246-250. doi: 10.1016/j.dsx.2018.09.002. Epub 2018 Sep 8.
Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes for chronic liver disease in Asians. It occurs more commonly in patients with type 2 diabetes mellitus (T2DM). However, data on prevalence and associations of NAFLD among Sri Lankans with diabetes are lacking. The main aim of this study is to investigate the prevalence and factors associated with NAFLD in a cohort of diabetic patients.
Total of 233 patients with type 2 diabetes mellitus, followed up at a diabetes center in Southern Sri Lanka, were recruited by convenience sampling method. Each of them underwent a detailed medical history, physical examination, laboratory investigations and abdominal ultrasonography(USS). The diagnosis of NAFLD was made according to the established criteria using USS.
The overall prevalence of NAFLD based on USS was 62.6% with no significant gender difference. Compared to USS, elevation in AST and ALT levels, based on NHANES III criteria, occurred only in 42% (98/234). The patients with NAFLD (56.7 ± 8.9) were significantly younger and had higher BMI and waist circumference, and raised AST and ALT than those without NAFLD. Binary logistic regression showed that the use of pioglitazone, higher BMI, and waist circumference were independently and significantly associated with NAFLD.
NAFLD is common in Sri Lankan patients with T2DM and central and global obesity are significant associations. Use of pioglitazone seemed to be protective against the development of NAFLD. These findings underscore the need for weight management as a preventive measure of NAFLD in T2DM patients.
非酒精性脂肪性肝病（NAFLD）是亚洲慢性肝病最常见的病因之一。它在2型糖尿病（T2DM）患者中更为常见。然而，关于斯里兰卡糖尿病患者中NAFLD的患病率及相关性的数据尚缺乏。本研究的主要目的是调查一组糖尿病患者中NAFLD的患病率及其相关因素。
采用方便抽样法招募了在斯里兰卡南部一家糖尿病中心接受随访的233例2型糖尿病患者。他们每个人都接受了详细的病史询问、体格检查、实验室检查和腹部超声检查（USS）。根据既定标准使用USS对NAFLD进行诊断。
基于USS的NAFLD总体患病率为62.6%，无显著性别差异。与USS相比，根据美国国家健康和营养检查调查（NHANES）III标准，AST和ALT水平升高仅发生在42%（98/234）的患者中。与无NAFLD的患者相比，患有NAFLD的患者（56.7±8.9岁）明显更年轻，BMI和腰围更高，AST和ALT水平也更高。二元逻辑回归显示，使用吡格列酮、较高的BMI和腰围与NAFLD独立且显著相关。
NAFLD在斯里兰卡T2DM患者中很常见，中心性肥胖和全身性肥胖是显著的相关因素。使用吡格列酮似乎对NAFLD的发生有保护作用。这些发现强调了体重管理作为T2DM患者预防NAFLD措施的必要性。
