title: Prevalence of and predictive factors for nonalcoholic fatty liver disease in Sudanese individuals with type 2 diabetes: Is metabolic syndrome the culprit?
abstract: OBJECTIVE
  Non-alcoholic fatty liver disease (NAFLD) is a common global chronic liver condition. The prevalence of NAFLD among individuals with type 2 diabetes is estimated to be as high as 75%. The aim of this study was to determine the prevalence of NAFLD among individuals with type 2 diabetes in Sudan.
  
  
  METHODS
  This was a cross-sectional hospital-based study, which was carried out at the Jabir Abu-Elizz diabetic centre in Khartoum; 167 outpatients with type 2 diabetes were enrolled. NAFLD was diagnosed based on ultrasound, following exclusion of significant alcohol intake and secondary causes of liver diseases. NAFLD was defined as hepatic steatosis in the absence of alcohol intake, medication, previous liver disease and negative results for the serological test for hepatitis B and C. Logistic regression analysis was used to determine independent risk factors for the development of NAFLD in individuals with type 2 diabetes.
  
  
  RESULTS
  The number of female subjects was 89 (53.3%), and most subjects (145, 86.8%) were between the ages of 40 and 70 years. The overall prevalence of fatty liver among individuals with type 2 diabetes was found to be 50.3%. Age, duration of diabetes, hypertension and HbA1c levels appeared to have no impact on the prevalence of NAFLD. The possible predictors of NAFLD were overweight, obesity, central obesity, high triglyceride level and low high-density lipoprotein cholesterol (HDL-c) level. A higher prevalence of NAFLD was observed in individuals with three components of the metabolic syndrome.
  
  
  CONCLUSIONS
  NAFLD was observed in half of the diabetic population, and its occurrence correlates positively with metabolic syndrome risk factors.
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan.
authors.forename: Ahmed O
authors.initials: AO
authors.lastname: Almobarak
authors.affiliation: National Center for GI & Liver Diseases, Ibn Sina Hospital, Ministry of Health, Khartoum, Sudan.
authors.forename: Salma
authors.initials: S
authors.lastname: Barakat
authors.affiliation: Federal Ministry of Health, Khartoum, Sudan.
authors.forename: Eltayeb A
authors.initials: EA
authors.lastname: Suliman
authors.affiliation: Department of Pathology, Faculty of Medicine, Nile Valley University, Atbara, Sudan.
authors.forename: Wadie M
authors.initials: WM
authors.lastname: Elmadhoun
authors.affiliation: Department of Medicine, Sentara Obici Hospital, Suffolk, VA, USA.
authors.forename: Nabeel A
authors.initials: NA
authors.lastname: Mohamed
authors.affiliation: Department of Statistics, Faculty of Mathematical Sciences - University of Khartoum, Khartoum, Sudan.
authors.forename: Israa O
authors.initials: IO
authors.lastname: Abobaker
authors.affiliation: Department of Medicine, Faculty of Medicine, Nile Valley University, Atbara, Sudan.
authors.forename: Sufian K
authors.initials: SK
authors.lastname: Noor
authors.affiliation: Department of Medicine, Faculty of Medicine, Nile Valley University, Atbara, Sudan.
authors.forename: Sarra O
authors.initials: SO
authors.lastname: Bushara
authors.affiliation: Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK. Electronic address: elziber@yahoo.com.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D013397:Sudan / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D008055:Lipids
keywords: Fatty liver; Metabolic syndrome; Obesity; Sudan; Type 2 diabetes