Sonographically Diagnosed Non-Alcoholic Fatty Liver as a Predictor of Metabolic Syndrome

Abstract

CONTEXTNon-alcoholic fatty liver disease (NAFLD) is the most common liver disease, since its prevalence is estimated to be 20-30% in general population of Western countries. Incidence of NAFLD in Indian population is on rise and its exact prevalence is not known. It was thought to be a benign condition, but is now increasingly recognized as a major cause of liver-related morbidity and mortality. Studies have proven that NAFLD may progress to cirrhosis, liver failure and hepatocellular carcinoma, in addition it has been shown that NAFLD is strongly associated to the features of Metabolic Syndrome (MetS). AIMS AND OBJECTIVESTo evaluate the association of sonographically diagnosed nonalcoholic fatty liver with metabolic syndrome and to estimate prevalence of nonalcoholic fatty liver in our population coming for general health check-up. METHODWe recruited 556 subjects, who visited for annual general health checkup at our institute. Based on exclusion criteria 148 subjects were excluded from the study and data from the remaining 408 subjects were included in the final statistical analysis. Characteristic ultrasound features such as increased hepatic echogenicity with attenuation of ultrasound beam and poor visibility of diaphragm and intrahepatic vessel borders were used to diagnose hepatic steatosis. RESULTOut of total 408 subjects who met with our inclusion criterias, 144 were diagnosed as having NAFLD (35.2%) on sonography examination. Mean age of subjects in NAFLD group was 49.54 years; 79% of subjects in NAFLD group in our study had BMI >25, out of which 28.47% were morbidly obese. Tobacco use and lack of physical activity was observed to be more prevalent in NAFLD group. Out of total 144 subjects with NAFLD 43.75% were having metabolic syndrome. This association was statistically extremely significant (P value <0.0001). Components of metabolic syndrome increased waist circumference, hypertension, impaired blood glucose level, low HDL cholesterol and high triglyceride level were more frequently observed in NAFLD group. CONCLUSIONIssue whether or not NAFLD should be included as one of the components of the MetS is still in existence; however, it can be concluded that NAFLD is an important independent risk factor for prediction of MetS. The observations of our study might be helpful to support the clinical guideline and early intervention strategy for the NAFLD patients before being diagnosed as MetS.