Prevalence and Profile of Fibrosis in Diabetic Patients with Non-alcoholic Fatty Liver Disease and the Associated Factors
Abstract: the risk of
Non-Alcoholic Fatty Liver Disease (NAFLD) is increasing in patients with type-2
diabetes. Prevalence and factors related to the increased risk of NAFLD in
diabetic patients in Indonesia has never been studied before. Data regarding
the profile of fibrosis in the population has also been unknown. This study
aimed to identify the difference on the profile of diabetic patients with and
without NAFLD as well as the degree of fibrosis. Methods: the study was
conducted using a cross-sectional method in type-2 diabetic patients who were
treated at the outpatient clinic of endocrinology and metabolic division in
Cipto Mangunkusumo Hospital. Sampling was done consecutively. Collected data
comprised of age, duration of diabetes, body mass index (BMI), waist
circumference, HDL, triglyceride, and HbA1C levels. Abdominal ultrasonography
was conducted for all patients to determine the presence of NAFLD. Patients
with NAFLD were subsequently underwent transient elastography in order to
assess their degree of liver fibrosis. Chi-square or Fisher’s-Exact tests were
used for bivariate analysis and logistic regression was used for multivariate
analysis. Results: as many as 186 patients were analyzed in the study and 84
patients (45.2%) were demonstrated to have NAFLD. Transient elastography
examinations were carried out in 68 patients and 17 patients (25.0%) were found
with severe fibrosis. Univariate analysis showed significant differences on BMI
(PR=1.878; 95%CI= 1.296-2.721; p<0.001) and waist circumference (PR=2.368;
95%CI= 1.117-5.017; p=0.018) between patients with and without NAFLD. However,
the multivariate test showed that BMI was the only factor that had a significance
difference between both groups (OR=2.989; 95%CI=1.625-5.499; p<0.001).
Conclusion: prevalence of NAFLD among type-2 diabetic patients in Cipto
Mangunkusumo Hospital has reached 45.2% and 25.0% among them had severe
fibrosis. BMI is the only factor found to be associated with the occurrence of
NAFLD.
Keywords: non-alcoholic fatty
liver disease (NAFLD); diabetes melitus; fibrosis
Author: Ignatius Bima
Prasetya, Irsan Hasan, Wismandari Wisnu, Cleopas Martin Rumende
Journal Code: jpkedokterangg170346
