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A comparative study between patients with nonalcoholic fatty liver disease and type 2 diabetes mellitus

Research Authors
رضا محمد البدوى*- سليمان محمد الحميد*-سها سعود عبد المنعم**- مها فهمى حمودة***-رجب حسين دنجل****
Research Journal
Journal of Hepatology, Gastroenterology & Infectious diseases 2011;12(1):23-30.
Research Rank
2
Research Vol
12(1)
Research Year
2011
Research_Pages
23-30
Research Abstract

Background: Nonalcoholic fatty liver (NAFLD) is emerging as a major health problem worldwide. An association between insulin resistant and obesity is confirmed. However, the relation between them and NAFLD has not been elucidated with non diabetic normal healthy subjects. The aim: Is to evaluate the use of simple biomarkers as predictors for NAFLD. Patients and Methods: Seventy seven Saudi Subjects divided into two groups: Group( 1) included 37 patients, 14 females and 23 males, known to have diabetes mellitus type 2 with age range of 42-59 years. Group( 2) included 40 healthy subjects who have no medical illness. The investigations were done for both groups, BMI, liver function tests, triglycerides, cholesterol, fasting blood sugar, fasting insulin, insulin resistance (HOMA-IR), leptin and abdominal ultrasonography. Results: There was a statistical significant difference for all laboratory parameters between both groups except for total bilirubin, direct bilirubin and ALT/AST ratio. In DM group patients with fatty liver was diagnosed in 22/37(54%) by abdominal ultrasound. The median values of TG, insulin, leptin, insulin resistant, ALT ,GGT,AST and ALT/AST ratio in diabetic patients were statistically significant higher in those with fatty liver compared with those without fatty liver (P values <0.05) In group 2 fatty liver was diagnosed by abdominal ultrasound in 12/40( 30%). The median values of FBS,TG, cholesterol, insulin, leptin, insulin resistant, ALT ,GGT,AST and ALT/AST ratio in the healthy subjects were statistically significant higher in those with fatty liver compared with those without fatty liver (P values <0.05).The sensitivity and specificity of GGT, ALT/AST ratio was as follow 100.%, 59% and 73%, 55% cut off value of 45 IU/l and 1.9 respectively. Conclusion: Elevated liver enzymes, although in normal ranges, at upper quartiles play a role in early diagnosis of fat overflow to the liver in addition to the other markers and abdominal ultrasound has a predictive value in early diagnosis of fatty liver.