Non-alcholic fatty liver disease in Type 2 Diabetes Mellitus: An independent predictor for Macro angiopathy and Micro angiopathy

Mohanraj, K (2014) Non-alcholic fatty liver disease in Type 2 Diabetes Mellitus: An independent predictor for Macro angiopathy and Micro angiopathy. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

INTRODUCTION : Nonalcoholic fatty liver disease is a condition in which there is collection of fat in liver cells mainly triglycerides. Nonalcoholic fatty liver disease is a condition most often present in association with Obesity. Nonalcoholic fatty liver disease has a strong association with glucose intolerance, insulin resistance, type 2 diabetes mellitus, either with or without obesity. In Indian population the prevalence of this disease is 15to 20 %, whereas the prevalence among diabetes population is more than two fold higher (50 to 75%). There is very strong association between nonalcoholic fatty liver disease and type 2 diabetes mellitus especially in obese individuals. Hyperlipidemia is a risk factor for the development of nonalcoholic fatty liver disease. The incidence of non-alcoholic fatty liver disease is higher in the diabetic population which may act as a predictor for diagnosis of micro and macrovasuclar disease .The micro and macrovasuclar disease have a great impact on economy of the patient. AIM OF THE STUDY : 1. To clarify the clinical characteristics of type 2 diabetic patients with non-alcoholic fatty liver disease (NAFLD). 2. To assess whether nonalcoholic fatty liver disease is related to diabetic micro and macroangiopathy. METHODS AND MATERIALS : This was an observational study done in Government Royapettah Hospital. The study recruited 100 patients who were admitted in the department of medicine and who attended diabetology department as out-patients. Those who fulfilled the inclusion and exclusion criteria were included in the study. In patients with type 2 Diabetes Mellitus, Fasting & postprandial glucose, lipid profile, liver function test with enzymes, Ultrasonogram, Urine spot albumin creatinine ratio, ECG, Carotid Doppler for Carotid Intimal Thickness, Ankle brachial index by Oscillometric method, urea, and creatinine will be done after obtaining written informed consent and the findings correlated to find out whether NAFLD is an independent indicator of angiopathy in these patients. OBSERVATION AND RESULTS : Out of 100 patients with diabetes 24 had retinopathy, 33 had peripheral arterial disease, 18 had peripheral neuropathy, 12 patients had cerebrovascular accident, 30 had ischemic heart disease, 31 patients are in grade 2 diabetic nephropathy, 1 patient is in grade 3 diabetic nephropathy and 1 patient is in grade 4 diabetic nephropathy. Out of 40 patients with NAFLD 17 had retinopathy, 18 had peripheral neuropathy, 18 had ischemic heart disease, 10 had cerebrovascular accident. Among NAFLD patients with peripheral arterial disease 11 had mild disease 2 had moderate disease 1 had severe disease. Among NAFLD patients with diabetic nephropathy 29 patients are in grade 1 diabetic nephropathy, 11 patients are in grade 2 diabetic nephropathy and there is no patient in grade 3 and grade 4nephropathy.the mean carotid intimal medial thickness is high among NAFLD group when compared with that of no NAFLD group (0.789 Vs 0.698). The prevalence of retinopathy (17 Vs 7), cerebrovascular accident (10 Vs 2), ischemic heart disease (18 Vs 12), peripheral neuropathy (18 Vs 0) is high among NAFLD group when compared to that of no NAFLD group all of which are statistically significant. The patients with NAFLD group had high BMI, high cholesterol, high blood pressure. CONCLUSION : The study concluded that the diabetic patients with nonalcoholic liver disease have high prevalence of ischemic heart disease, diabetic retinopathy, diabetic peripheral neuropathy, cerebrovascular accident and have increased carotid intimal medial thickness. The diabetic patients with nonalcoholic liver disease did not have any relation with diabetic nephropathy and peripheral arterial disease. The patients with NAFLD group had high BMI, high cholesterol, high blood pressure (both systolic and diastolic) high triglyceride levels. Thus NAFLD in type 2 diabetes mellitus independently predicts of diabetic microangiopathy and diabetic macroangiopathy the characteristics of NAFLD in type 2 diabetes mellitus are studied.

Item Type: Thesis (Masters)
Uncontrolled Keywords: nonalcoholic fatty liver disease, Type 2 diabetes mellitus, diabetic macroangiopathy, coronary heart disease.
Subjects: MEDICAL > General Medicine
Depositing User: Punitha K
Date Deposited: 31 Jul 2017 12:07
Last Modified: 04 Feb 2018 02:11
URI: http://repository-tnmgrmu.ac.in/id/eprint/2402

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