High Prevalence of Hepatic Steatosis and Hepatic Fibrosis in Patients with Type 2 Diabetes Mellitus

Summary Aim To determine the prevalence of hepatic steatosis and fibrosis in patients with T2DM from North India. Research design and methods : In this cross-sectional study, Asian Indian patients with T2DM (n,250) underwent liver ultrasonography (USG), Fibroscan for assessment of hepatic steatosis (Controlled Attenuation Parameter, CAP) and hepatic fibrosis (Kilopascals, kPa), respectively. Pearson’s correlation analysis & logistic regression analysis for significant predictors of hepatic steatosis and fibrosis were done. The cut-off value of liver span was calculated by ROC-AUC analysis. Results Grade 3 hepatic steatosis was seen in 213 (85.2 %) of T2DM patients, higher in males than females and in those with high BMI values. Any degree of fibrosis and severe fibrosis were seen in 205 (62%) and 46 (18.4%) patients, respectively; higher in males, with BMI >30kg/m2, and those with >5 years duration of diabetes. BMI and SGPT are significant predictors of hepatic steatosis. An increase of 1 unit in BMI above 23 kg/m2 led to 19.6 times increased risk of hepatic steatosis. SGOT and GGTP were significant predictors of any hepatic fibrosis. On ROC AUC analysis, liver size cut-off value ≥ 16.4 cms (sensitivity: 65% sensitivity, specificity:65 %) was predictive of hepatic fibrosis. Conclusion High prevalence of grade 3 hepatic steatosis and hepatic fibrosis needs increased vigilance and corrective lifestyle and pharmacological measures. Asian Indian patients with T2DM and BMI >30kg/m2, >5 years duration of diabetes & ultrasound derived liver span ≥16.4 cm should be further evaluated for hepatic fibrosis.