Assessing Non-Alcoholic Fatty Liver Disease and Associated Liver Enzyme Levels in Persons with Type II Diabetes Mellitus

Abstract

Background: This study aims to assess the prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) among individuals with diabetes and identify the associated factors that contribute to its development. By investigating this relationship, we hope to gain valuable insights into the shared underlying mechanisms of these conditions and inform the development of more targeted preventive and therapeutic strategies. Methods: 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: The study found that 25% of the total participants had NAFLD. Among the diabetic patients, the prevalence of NAFLD was significantly higher at 32.7% compared to 17.3% in the control group. On average, individuals with NAFLD exhibited significantly higher ALT levels (33.4 ± 10.7) compared to those without the disease (18.1 ± 6.9), with a highly statistically significant p-value of 0.0001.  Similarly, AST levels mirrored this pattern, showing a marked elevation in the NAFLD group (32.0 ± 11.5) compared to the control group (14.6 ± 6.8), again with a statistically significant p-value of 0.0001.  Regression analyses showed that individuals with elevated ALT levels were over 10 times more likely to have NAFLD compared to those with normal ALT (OR: 10.4, 95% CI: 1.3 – 18.7). Similarly, elevated AST levels were associated with an over 7-fold increased risk of NAFLD (OR: 7.5, 95% CI: 4.5 – 8.2). Conclusion: Elevated liver enzymes in NAFLD patients suggest ongoing liver inflammation and potential progression towards more severe liver conditions. Combining lifestyle interventions with targeted pharmacological treatments provides the most effective approach for mitigating NAFLD progression. Tailoring these strategies to individual patient profiles, alongside regular monitoring, ensures optimized outcomes and prevention of severe complications.