Prevalence of non-alcoholic fatty liver disease in patients with prediabetes

Background. Diabetes mellitus (DM) is one of the largest global health emergencies. Prediabetes is an early stage in hyperglycemia continuum where individual is at an increased risk for development of DM. NAFLD represents a range of liver disorders characterized by hepatic steatosis or accumulation of fat in the liver cells in the absence of excessive alcohol consumption, viral or drug related etiologies. However, not many studies have been conducted to study the prevalence of non-alcoholic fatty liver disease (NAFLD) in persons with prediabetes. This study is an endeavor in that direction. Materials and methods. This was a cross-sectional observational study. 100 prediabetic patients, fulfilling the criteria as under, were included in the study over a period from November 2017 to March 2019, after informed consent. Investigations carried out on the patients included baseline biochemical parameters like complete hemogram, fasting plasma glucose, liver function tests, kidney function tests, serum electrolytes and specialized investigations like HbA1c, 2-hour-OGTT and serum insulin levels. Results. The study included 38 males and 62 females, with the median age for the study population being 46 years. The mean BMI was found to be 24.29 ± 3.98 kg/m, and the mean waist circumference was found to be 81.26 ± 8.71 cm. A significant association was found between the level of fatty echotexture on ultrasound and BMI (p = 0.003), and gender (0.05). 30 % population was found to be insulin sensitive, 22 % was found to be depicting early insulin resistance and 48 % had significant insulin resistance. There was a statistically significant correlation between ultrasound and fibroscan findings. A significant statistical correlation was found between HOMA IR and level of fatty echotexture on ultrasound, as well as median liver stiffness on fibroscan. Conclusions. We found a significant correlation between insulin resistance and presence of NAFLD. Also, significant associations were observed between various demographic characteristics and grade of steatosis. There is a need to undertake further studies on a larger scale, to substantiate the observations of this study. This understanding is expected to go a long way in generating awareness and optimizing public health strategies.