Determination of frequency of diabetes and pre-diabetes in patients with nonalcoholic fatty liver disease and comparison with a control group

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Western industrialized countries. The pathogenesis of NAFLD has not been clearly determined, but the most widely supported theory is the mechanism of insulin resistance. Therefore, the aim of this study was to evaluate the frequency of diabetes and pre-diabetes in patients with NAFLD. Methods: The present study was performed on 80 patients and 26 healthy controls matched for age and sex. Patients were diagnosed with NAFLD through ultrasound and were selected. From each participant, a 5 cc sample of blood was obtained and sent to a pathology laboratory for analysis. Quantitative data and qualitative data were analyzed using t-test and chi-square test, respectively. Moreover, multivariate tests, such as regression tests, were used where necessary. Findings: Among the participants, 64 (60.3) were women and 42 (39.7) were men. The average age of the subjects in the case group was 48.8 ± 10.8 years and in the control group was 42.3 ± 13.4 years. Of the 106 participants, 44 patients (41.5) had pre-diabetes and 11 (10.4) had diabetes; all were in the case group. In the control group, no subjects had pre-diabetes (P-value < 0.001) or diabetes (P-value = 0.046). After removing age as a confounder, the only variables that differed significantly between the two groups and were higher in the case group were hemoglobin A1c (HbA1c), fasting plasma glucose, insulin, cholesterol, aspartate transaminase (AST), alanine transaminase (ALT), two-hour blood glucose. Moreover, with the removal of BMI as a confounder, only hemoglobin A1C, fasting blood glucose, insulin, and ALT showed significant differences between the two groups. Conclusion: This study showed that the prevalence of diabetes in patients with NAFLD was high. Even with the removal of confounding factors, factors associated with diabetes, such as hemoglobin A1c, fasting plasma glucose, and insulin, had significant association with this disease, indicating a strong relationship between the two diseases. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved.