Screening for Non-alcoholic Liver Disease in Type 2 Diabetic Patients and its Association with Age, BMI and Duration of Diabetes Mellitus- A Cross-sectional Study

Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) and Type 2 Diabetes share a bidirectional relationship. NAFLD can increase the severity of diabetic microvascular and macrovascular complications. Ultrasonography, the most commonly used method of assessment of NAFLD in India, is associated with intra-operator variability and false positives. Transient elastography and Liver Stiffness Measurement (LSM) have emerged as one of the best modalities to screen NAFLD in people with diabetes. Aim: Screening for NAFLD in people with Type 2 Diabetes and its association with age, Body Mass Index (BMI) and duration of diabetes. Materials and Methods: This was a prospective crosssectional study conducted on patients with known Type 2 Diabetes Mellitus (T2DM) who visited the study center between July 2019 and November 2019 for consultation. A total of 287 people with diabetes were subjected to FibroScan test and LSM was done. The other variables-age, gender, duration of diabetes, height, weight, BMI and HbA1c were recorded for all subjects and the collected data was correlated using Spearman rho test. Results: The study population included 61% males and 39% females. The mean age was 46.96 years and the mean duration of diabetes was 10.98 years. The mean Glycated haemoglobin (HbA1c) value was 9.28%. The median value of LSM by M probe was 7.16. Out of the total, 78 (27.2%) were identified with advanced fibrosis with LSM >9.6. Advanced fibrosis was strongly correlated with HbA1c (r=0.820), age (r=0.562) and duration of diabetes (r=0.596) and moderately with BMI (r=0.375). Conclusion: The screening of people with type 2 diabetes for NAFLD using LSM revealed 27.2% subjects with advanced fibrosis, it correlated positively with age, BMI and duration of diabetes.