Non-alcoholic steatohepatitis in type 2 diabetes mellitus.
OBJECTIVE
Non-alcoholic steatohepatitis (NASH) is commonly associated with type 2 diabetes mellitus (DM). Prevalence of NASH in type 2 DM has not been well studied and there is an epidemic rise in type 2 DM in Asian and Western populations. Its association with chronic liver disease in the form of NASH makes it an important health problem. Hence we have studied its prevalence and correlation of biochemical parameters with histological grades of non-alcoholic fatty liver disease (NAFLD) in otherwise asymptomatic type 2 DM patients.


METHODS
One hundred and forty-eight individuals were screened. Forty-eight individuals were excluded due to history of alcohol intake or liver disease as a result of other causes. One hundred non-alcoholic individuals with type 2 DM underwent abdominal ultrasonography (US abdomen). Forty-nine patients had evidence of fatty liver on US abdomen, and 32 of these 49 patients underwent liver biopsy.


RESULTS
Four of 32 (12.5%) individuals had steatosis alone. Mild, moderate and severe NASH was present in 21/32 (65.5%), 4/32 (12.5%) and 3/32 (9.35%), respectively. Fibrosis was present in 7/32 (21.8%) patients (four grade 1 and three grade 3). There was no significant difference in body mass index (BMI), transaminase levels, serum cholesterol and triglyceride levels among patients with non-alcoholic fatty liver disease.


CONCLUSIONS
We conclude that the prevalence of NASH is high in type 2 DM patients and liver biopsy is the only investigation to differentiate between non-alcoholic fatty liver and steatohepatitis.
Gupte
Parijat
P
Gastroenterology Center, Jagjivanram Hospital, Mumbai Central, Mumbai, Maharashtra, India.
Amarapurkar
Deepak
D
Agal
Subhash
S
Baijal
Rajiv
R
Kulshrestha
Pramod
P
Pramanik
Snehansu
S
Patel
Nikhil
N
Madan
Aruna
A
Amarapurkar
Anjali
A
Hafeezunnisa
D001707:Biopsy, Needle; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005234:Fatty Liver / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D008055:Lipids / Q000097:blood; D008111:Liver Function Tests; D008297:Male; D015995:Prevalence; D011446:Prospective Studies
D008055:Lipids