Non-Alcoholic Fatty Liver Disease and Associated Lipid Profile in Type 2 Diabetes Patients of Nigeria

Abstract

Background: Type II diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) are rising chronic conditions that often co-occur, posing significant health risks. NAFLD is common among those with T2DM due to shared risk factors like insulin resistance and obesity. Understanding this link is crucial for effective prevention and treatment. This article explores the relationship between NAFLD and lipid profiles in individuals with T2DM. Method: The study was carried out at the University of Port Harcourt Teaching Hospital (UPTH), Rivers State, Nigeria. The study included 300 participants aged 18 and above, consisting of 150 diabetic patients and 150 age- and sex-matched controls. Participants underwent clinical, biochemical, and anthropometric assessments. Blood samples were collected to analyze liver enzymes, glucose, and lipid profiles according to standard laboratory procedures. Additionally, all subjects received abdominal ultrasound examinations to detect hepatic steatosis, indicative of NAFLD. Results:  There was a 32.7% prevalence of NAFLD among the diabetic patients. Regression analysis show that individuals with uncontrolled diabetes are significantly more likely to have NAFLD The odds ratio was 7.3 (95% CI: 2.6 – 20.1; p = 0.0001). Also, an odds ratio of 4.9 (95% CI: 1.5 – 15.3), suggests a strong association between elevated triglycerides and NAFLD. For high-density lipoprotein (HDL) levels, none of the individuals with elevated HDL had NAFLD, whereas 100% of them were without NAFLD. This difference was also significant, with a chi-square value of 11.25 (p=0.0041). Conclusion: People with type 2 diabetes face a complex interplay between blood sugar control, cholesterol levels, and NAFLD. This study found that poor blood glucose control (high HbA1c) and high triglycerides significantly increase NAFLD risk, while higher HDL levels offer some protection. LDL levels weren't directly linked to NAFLD, and standard liver tests for bilirubin and albumin were less informative. The study recommends regular NAFLD screening, especially for patients with poor blood glucose control or high triglycerides, and a comprehensive treatment approach to manage blood glucose, triglycerides, and potentially increase HDL. Tailoring treatment to individual risk profiles and educating patients on healthy habits is essential.