Association of non-alcoholic fatty liver disease (NAFLD) and insulin resistance in type 2diabetes

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of nonalcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma and is a major risk factor in hepatic insulin resistance (IR). IR appears to be a common pathophysiological link between NAFLD and type 2 diabetes mellitus (T2DM) and limited information is available on the association of NAFLD with IR in T2DM individuals. We decided to determine whether there is association of NAFLD with IR in T2DM subjects. Material & Methods: Study involving 151 (53 males, 98 females) T2DM subjects were screened for NAFLD using abdominal ultrasound scanning, clinical assessment and biochemical parameters. IR was calculated using HOMA-IR. Association between NAFLD and IR was tested by Chi-square analysis. Significant difference between NAFLD and non-NAFLD subgroups was analyzed by t-test and z-test. Results: The prevalence of NAFLD, IR and hypertension in T2DM subjects were found to be 73%, 81% and 80% respectively. There was no significant difference in the prevalence of these between male & female. However, the prevalence of obesity and central obesity was significantly high in females. The comparison between NAFLD and non-NAFLD subgroups showed significantly high prevalence of IR, hypertension, obesity, central obesity, elevated SGPT and TG in NAFLD group. However, there was no significant difference in mean values of serum biochemical parameters except TG, VLDL and SGPT. NAFLD showed strong association with IR (OR 13). Conclusion: The study indicated high prevalence of NAFLD and IR and; strong association between them in diabetic population.