11. Risk factors for development of diabetes mellitus in non-alcoholic fatty liver disease (NAFLD) patients

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a distinct clinicopathologic entity characterized histologically by a spectrum ranging from simple steatosis to steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma (HCC).Objective: To determine the incidenceand identify the risk factors of NAFLD in non-obese patients.Methods: It was a cross sectional study done in Department of gastroenterology, Nuclear Medicine and ultrasound, Radiology and Imaging, Virology, Biochemistry, BSMMU, Dhaka from March 2012 to June 2014. The patients more or equal to 18 years, non-obese were included. In this study total 190 patients were enrolled.Results: Among them 38 patients were with fatty liver and 152 patients without fatty liver on the basis of ultrasonogram. Where 141 were male and 49 were female with mean age was 49.24 + 9.05 years. Among total, 18.9% had diabetes mellitus, 28.4% had dislipidaemia 24.4% had history of hypertension. Total 18.9% patients having history of diabetes mellitus, normal vs fatty liver disease (20% vs 42.1%, p <0.001) and history of dyslipidemia (10.5% vs 100% , p <0.001), Haemoglobin percentage was 12.16 + 1.32 gm/dL, urine routine microscopic examination glucose present in 9.5% patients. SGPT 56.34 + 16.09 IU/L, SGOT 41.62 + 5.94 IU/L, alkaline phosphatase 99.31+ 19.76 IU/L. We found 6.3% patients were HBsAg positive and no patient was Anti HCV positive.Conclusion: Sedentary life style, Metabolic syndrome, DM, dyslipidameia, are risk factors of NAFLD in non obese person. Elevated liver enzymes are consequences of NAFLD. Though this study has some limitations, it will give some information about emerging liver disease without viral hepatitis.J MEDICINE July 2015; 16 (2) : 89-92

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Lean non-alcoholic fatty liver disease (Lean-NAFLD): characteristics and risk factors from a community cohort follow up study

10.26226/morressier.57c5383fd462b80296c9b9f3 ◽

2016 ◽

Author(s):

Madunil Niriella

Keyword(s):

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Follow Up Study ◽

Lean Nafld ◽

Alcoholic Fatty Liver Disease

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Evaluation the Predictors of Non-Alcoholic Fatty Liver Disease (NAFLD) in Type 2 Diabetes Mellitus (T2DM) Patients

Systematic Reviews in Pharmacy ◽

10.31838/srp.2020.5.58 ◽

2020 ◽

Vol 11 (05) ◽

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Have we learnt all from Improve-It? Part I. Core results and subanalyses on the effects of ezetimibe added to statin therapy related to age, gender and selected chronic diseases (kidney disease, diabetes mellitus and non- alcoholic fatty liver disease)

Current Vascular Pharmacology ◽

10.2174/1570161118999200727224946 ◽

2020 ◽

Vol 18 ◽

Author(s):

Zlatko Fras ◽

Dimitri P. Mikhailidis

Keyword(s):

Diabetes Mellitus ◽

Liver Disease ◽

High Risk ◽

Kidney Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Risk Patients ◽

Very High ◽

Alcoholic Fatty Liver Disease

: IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial) was a randomized clini- cal trial (18,144 patients) that evaluated the efficacy of the combination of ezetimibe with simvastatin vs simvastatin mono- therapy in patients with acute coronary syndrome (ACS) and moderately increased low-density lipoprotein cholesterol (LDL-C) levels (of up to 2.6-3.2 mmol/L; 100-120 mg/dL). After 7 years of follow-up, combination therapy resulted in an additional LDL-C decrease [1.8 mmol/L, or 70 mg/dL, within the simvastatin (40 mg/day) monotherapy arm and 1.4 mmol/L, or 53 mg/dL for simvastatin (40 mg/day) + ezetimibe (10 mg/day)] and showed an incremental clinical benefit (composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary re- vascularization (≥30 days after randomization), or nonfatal stroke; hazard ratio (HR) of 0.936, and 95% CI 0.887-0.996, p=0.016). Therefore, for very high cardiovascular risk patients “even lower is even better” regarding LDL-C, independently of the LDL-C reducing strategy. These findings confirm ezetimibe as an option to treat very-high-risk patients who cannot achieve LDL-C targets with statin monotherapy. Additional analyses of the IMPROVE-IT (both prespecified and post-hoc) include specific very-high-risk subgroups of patients (those with previous acute events and/or coronary revascularization, older than 75 years, as well as patients with diabetes mellitus, chronic kidney disease or non-alcoholic fatty liver disease). The data from IMPROVE-IT also provide reassurance regarding longer-term safety and efficacy of the intensification of li- pid-lowering therapy in very-high-risk patients resulting in very low LDL-C levels. We comment on the results of several (sub) analyses of IMPROVE-IT.

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Non-alcoholic fatty liver disease in polycystic ovary syndrome women

Scientific Reports ◽

10.1038/s41598-021-86697-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Young Bin Won ◽

Seok Kyo Seo ◽

Bo Hyon Yun ◽

SiHyun Cho ◽

Young Sik Choi ◽

...

Keyword(s):

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Liver Enzyme ◽

Fatty Liver Disease ◽

Polycystic Ovary ◽

Insulin Level ◽

University Hospital ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

AbstractTo evaluate risk factors leading to non-alcoholic fatty liver disease (NAFLD) occurrence in polycystic ovarian syndrome (PCOS) women. A retrospective cohort study of a total of 586 women diagnosed with PCOS aged 13–35 years at the gynecology department at a university hospital was done to evaluate PCOS phenotype, metabolic syndrome (MetS) diagnosis, body composition, insulin sensitivity, sex hormones, lipid profile, liver function, and transient elastography (TE). In PCOS women with NAFLD compared to those without, MetS diagnosis (Hazard ratio [HR] 5.6, 95% Confidence interval [CI] 2.2–14.4, p < 0.01) and hyperandrogenism (HA) (HR 4.4, 95% CI 1.4–13.4, p = 0.01) were risk factors significantly associated with subsequent NAFLD occurrence, whereas 2-h insulin level in 75 g glucose tolerance test (GTT) (HR 1.2, 95% CI 0.5–2.5, p = 0.70) and body mass index (BMI) > 25 kg/m2 (HR 2.2, 95% CI 0.6–8.0, p = 0.24) was not. Among NAFLD patients who underwent TE, a higher number of MetS components indicated a worse degree of fibrosis and steatosis. MetS diagnosis and HA at PCOS diagnosis were risk factors associated with NAFLD, while 2-h insulin level in 75 g GTT and obesity were not. Although elevated aspartate aminotransferase levels were significant for NAFLD risk, liver enzyme elevations may not be present until late liver damage. Further prospective studies of PCOS women with MetS or HA are warranted to determine whether patients without liver enzyme elevations should undergo preemptive liver examinations.

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Implementation of a care bundle improves the management of patients with non-alcoholic fatty liver disease

Frontline Gastroenterology ◽

10.1136/flgastro-2020-101480 ◽

2021 ◽

pp. flgastro-2020-101480

Author(s):

Laura Jane Neilson ◽

Louise Macdougall ◽

Phey Shen Lee ◽

Timothy Hardy ◽

David Beaton ◽

...

Keyword(s):

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Metabolic Risk Factors ◽

Care Bundle ◽

Metabolic Risk ◽

Lifestyle Advice ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

BackgroundNon-alcoholic fatty liver disease (NAFLD) is common and is associated with liver-related and cardiovascular-related morbidity. Our aims were: (1) to review the current management of patients with NAFLD attending hospital clinics in North East England (NEE) and assess the variability in care; (2) develop a NAFLD ‘care bundle’ to standardise care; (3) to assess the impact of implementation of the NAFLD care bundle.MethodsA retrospective review was conducted to determine baseline management of patients with NAFLD attending seven hospitals in NEE. A care bundle for the management of NAFLD was developed including important recommendations from international guidelines. Impact of implementation of the bundle was evaluated prospectively in a single centre.ResultsBaseline management was assessed in 147 patients attending gastroenterology, hepatology and a specialist NAFLD clinic. Overall, there was significant variability in the lifestyle advice given and management of metabolic risk factors, with patients attending an NAFLD clinic significantly more likely to achieve >10% body weight loss and have metabolic risk factors addressed. Following introduction of the NAFLD bundle 50 patients were evaluated. Use of the bundle was associated with significantly better documentation and implementation of most aspects of patient management including management of metabolic risk factors, documented lifestyle advice and provision of NAFLD-specific patient advice booklets.ConclusionThe introduction of an outpatient ‘care bundle’ led to significant improvements in the assessment and management of patients with NAFLD in the NEE and could help improve and standardise care if used more widely.

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