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Hosseini SA, Shayesteh AA, Hashemi SJ, Rahimi Z, Saki N, Bavi Behbahani H, Cheraghian B, Alipour M. The association between healthy eating index-2015 with anthropometric, cardiometabolic and hepatic indices among patients with non-alcoholic fatty liver disease. BMC Gastroenterol 2024; 24:159. [PMID: 38724894 PMCID: PMC11084087 DOI: 10.1186/s12876-024-03222-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/04/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Obesity, cardiovascular diseases, and metabolic disorders are common problems among participants with non-alcoholic fatty liver disease (NAFLD). However, the association between these problems and the healthy eating index-2015 (HEI-2015) remains unknown. Although the HEI-2015 originated from American dietary guidelines, its comprehensive evaluation of diet quality provides valuable insights for various populations, including Iranians. Therefore, the objective of this study was to investigate the association between anthropometric, hepatic, and cardio-metabolic indices with HEI-2015 scores in participants with NAFLD. METHODS We conducted a cross-sectional analysis of data from the Hoveyzeh Cohort Study, which included adults aged 35 to 70 years between 2016 and 2018. A total of 664 participant with NAFLD (452 females and 212 males) were included in the analysis. The HEI-2015 was assessed using the Food Frequency Questionnaire (FFQ). Various indices, including the body shape index (ABSI), atherogenic index of plasma (AIP), visceral adiposity index (VAI), lipid accumulation product (LAP), cardiometabolic index (CMI), lipoprotein combine index (LCI), AST/ALT ratio, ALD/NAFLD index, and hepatic steatosis index (HSI), were calculated. RESULTS No significant differences were observed in anthropometric, cardio-metabolic, and hepatic indices across the quartiles of HEI-2015. However, among participants with NAFLD, men had significantly higher AIP and LCI levels, while women had significantly higher BMI, ABSI, VAI, LAP, and CMI levels. Additionally, women with NAFLD exhibited higher AST/ALT and HSI levels but lower ALD/NAFLD levels compared to men with NAFLD. Linear regression analysis among men with NAFLD revealed a significant negative correlation between HEI-2015 score and HSI in both the unadjusted model (β=-0.131, SE = 0.058, p = 0.024) and the adjusted model for energy intake (β=-0.129, SE = 0.058, p = 0.028). CONCLUSION The present study demonstrated a correlation between lower HEI-2015 scores and an increased risk of steatosis in men with NAFLD. Moreover, our findings highlighted gender-related differences in NAFLD and cardio-metabolic disorders.
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Affiliation(s)
- Seyed Ahmad Hosseini
- Nutrition and Metabolic Disease Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Akbar Shayesteh
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Jalal Hashemi
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Rahimi
- Hearing Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Saki
- Hearing Research Center, Clinical Sciences Research Institute, Department of Otolaryngology, Head and Neck Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Bavi Behbahani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Bahman Cheraghian
- Hearing Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Meysam Alipour
- Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran.
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Han X, Zhang X, Liu Z, Fan H, Guo C, Wang H, Gu Y, Zhang T. Prevalence of nonalcoholic fatty liver disease and liver cirrhosis in Chinese adults with type 2 diabetes mellitus. J Diabetes 2024; 16:e13564. [PMID: 38664879 PMCID: PMC11045916 DOI: 10.1111/1753-0407.13564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) and liver cirrhosis are significant clinical concerns, especially among individuals with type 2 diabetes mellitus (T2DM). However, in China, there is a paucity of reliable evidence detailing the characteristics of NAFLD and liver cirrhosis in T2DM. Furthermore, the relationship between blood glucose levels and NAFLD prevalence remains unclear. METHODS Data from the Shanghai Suburban Adult Cohort and Biobank were analyzed, including 6621 participants with T2DM. NAFLD was diagnosed by ultrasonography and liver cirrhosis was performed according to the health information systems. Logistic regression and restricted cubic spline analysis were used to explore the potential risk factors for NAFLD and liver cirrhosis. RESULTS The prevalence of NAFLD was 59.36%, and liver cirrhosis was 1.43% among T2DM patients. In these patients, factors like age, being female, marital status, and obesity significantly increased the risk of NAFLD. Specifically, obesity had a strong positive association with NAFLD (odds ratio [OR] = 4.70, 95% confidence interval [CI]: 4.13-5.34). The higher glycated hemoglobin (HbA1c) quartile was associated with a heightened NAFLD risk compared to the lowest quartile (all p < .001). The HbA1c-NAFLD relationship displayed a linear that mimicked an inverted L-shaped pattern. A significant positive association existed between HbA1c levels and NAFLD for HbA1c <8.00% (OR = 1.59, 95% CI: 1.44-1.75), but this was not observed for HbA1c >8.00% (OR = 1.03, 95% CI: 0.92-1.15). CONCLUSION Systematic screening for NAFLD is essential in T2DM patients, especially with poor glucose control and obesity in female.
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Affiliation(s)
- Xinyu Han
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Key Laboratory of Public Health Safety (Fudan University)Ministry of EducationShanghaiChina
| | - Xin Zhang
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Key Laboratory of Public Health Safety (Fudan University)Ministry of EducationShanghaiChina
| | - Zhenqiu Liu
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life SciencesFudan UniversityShanghaiChina
- Fudan University Taizhou Institute of Health SciencesTaizhouChina
| | - Hong Fan
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Key Laboratory of Public Health Safety (Fudan University)Ministry of EducationShanghaiChina
| | - Chengnan Guo
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Key Laboratory of Public Health Safety (Fudan University)Ministry of EducationShanghaiChina
| | - Haili Wang
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Key Laboratory of Public Health Safety (Fudan University)Ministry of EducationShanghaiChina
| | - Yu Gu
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Key Laboratory of Public Health Safety (Fudan University)Ministry of EducationShanghaiChina
| | - Tiejun Zhang
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Key Laboratory of Public Health Safety (Fudan University)Ministry of EducationShanghaiChina
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public HealthFudan UniversityShanghaiChina
- Yiwu Research InstituteFudan UniversityYiwuChina
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Park KY, Park JH, Han K, Yu SH, Lee CB, Kim DS, Park HK, Hwang HS, Hong S. Fatty Liver Change in Older Adults as an Important Risk Factor for Type 2 Diabetes: A Nationwide Cohort Study. Mayo Clin Proc 2023; 98:1809-1819. [PMID: 37804267 DOI: 10.1016/j.mayocp.2023.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/16/2023] [Accepted: 02/28/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE To examine the association between changes in fatty liver disease (FLD) over time and the risk of type 2 diabetes in elderly individuals with prediabetes. METHODS A total of 156,984 elderly individuals with prediabetes who underwent national health screening in 2009 and 2011 were followed up through December 31, 2019. The FLD status was defined as a change in the fatty liver index. Prediabetes was defined as impaired fasting glucose levels at baseline. Multivariable Cox proportional hazards regression was used to calculate the hazard ratio and CIs for type 2 diabetes according to the changes in FLD. RESULTS During a median of 8.35 years of follow-up, type 2 diabetes developed in 29,422 (18.7%) elderly individuals with prediabetes. Multivariable adjusted hazard ratio of type 2 diabetes according to FLD change was 2.22 (95% CI, 2.11 to 2.34) in individuals with persistent FLD compared with those who have never had FLD. Although overall weight loss of 5% or more was associated with a 7% lower risk of type 2 diabetes in total participants, fatty liver status was important. Even with weight loss, those with a history of fatty liver-resolved FLD, new FLD, or persistent FLD-had an increased risk of type 2 diabetes. The risk of type 2 diabetes did not increase in individuals with sustained FLD-free status, regardless of weight change. CONCLUSION The presence and change of FLD are important factors for the development of type 2 diabetes in elderly individuals with prediabetes.
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Affiliation(s)
- Kye-Yeung Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Jung Hwan Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Sung Hoon Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, South Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, South Korea
| | - Dong Sun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Hoon-Ki Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Hwan-Sik Hwang
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Sangmo Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, South Korea.
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Li MR, Li JZ, Li JY, Wang CC, Yuan RK, Ye LH, Liu YY, Liang XJ, Zhang HC, Liu ZQ, Zeng DY, Zhang XD, Wang DH, Li JQ, Li TY, Yang L, Cao Y, Pan Y, Lin XG, Pan CQ, Dai EH, Dong ZY. Clinical Features of Non-Alcoholic Fatty Liver Disease in the Non-Lean Population. Obes Facts 2023; 16:427-434. [PMID: 37231905 PMCID: PMC10601616 DOI: 10.1159/000530845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION The prevalence of non-alcoholic fatty liver disease (NAFLD) in non-lean patients is significantly increased, and obesity significantly increases the risk of cirrhosis and HCC in NAFLD patients. However, whether there is a difference in clinical manifestations of NAFLD between overweight and obesity remains unclear. The objective of this study was to assess the clinical and histological features of NAFLD among a non-lean population. METHODS Current study enrolled consecutive non-lean (body mass index [BMI] >23 kg/m2) patients with NAFLD and available liver biopsy results. Patients were stratified by BMI into two groups for the comparison of their clinical and histological variables, which included the overweight (BMI 23∼<28 kg/m2) and the obese (BMI ≥28 kg/m2). Risk factors for moderate to severe fibrosis (stage >1) were also analyzed through the logistic regression model. RESULTS Among 184 non-lean patients with metabolic-associated fatty liver disease enrolled, 65 and 119 were overweight and obese, respectively. Patients in the obesity group had a significantly lower level of gamma-glutamyl transpeptidase, higher levels of platelet, glucose, prothrombin time, and more common of moderate to severe inflammatory activity when compared to those in the overweight group. However, a significant low frequency of moderate to severe fibrosis was found in the obesity group versus the overweight group (19.33% vs. 40.00%, p = 0.002). Binary logistics regression analysis of fibrosis found that aspartate transaminase (AST), BMI, alanine transaminase (ALT), and cholesterol (CHOL) were independent predictors for moderate to severe fibrosis in non-lean patients with NAFLD. Compared with the traditional fibrosis-4 (AUC = 0.77) and aminotransferase to platelet ratio index (AUC = 0.79) indexes, the combined index based on AST, BMI, ALT, and CHOL was more accurate in predicting moderate to severe fibrosis in non-lean patients with NAFLD (AUC = 0.87). CONCLUSIONS Clinical and histological features differed between obesity and overweight patients with NAFLD. When compared to the traditional serum markers, the combination index including AST, BMI, ALT, and CHOL provided a better model to predict moderate to severe fibrosis in non-lean patients with NAFLD.
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Affiliation(s)
- Min-ran Li
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jin-zhong Li
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jie-ying Li
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Cun-chuan Wang
- Bariatric and Metabolic Surgery Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rui-kun Yuan
- Division of Infectious Disease, The Sixth Affiliated Hospital of Jinan University, Dongguan, China
| | - Li-hong Ye
- Division of Pathology, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Yun-yan Liu
- Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Xu-jing Liang
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hai-cong Zhang
- Division of Pathology, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Zhi-quan Liu
- Division of Pathology, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Dong-yu Zeng
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | | | - De-hua Wang
- Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Jun-qing Li
- Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Tao-yuan Li
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Liu Yang
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yang Cao
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yun Pan
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xun-ge Lin
- Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Calvin Q. Pan
- Department of Infectious Disease, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Division of Gastroenterology and Hepatology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Er-hei Dai
- Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Zhi-yong Dong
- Bariatric and Metabolic Surgery Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Kosmalski M, Śliwińska A, Drzewoski J. Non-Alcoholic Fatty Liver Disease or Type 2 Diabetes Mellitus—The Chicken or the Egg Dilemma. Biomedicines 2023; 11:biomedicines11041097. [PMID: 37189715 DOI: 10.3390/biomedicines11041097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/28/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
In clinical practice, we often deal with patients who suffer from non-alcoholic fatty liver disease (NAFLD) concurrent with type 2 diabetes mellitus (T2DM). The etiopathogenesis of NAFLD is mainly connected with insulin resistance (IR) and obesity. Similarly, the latter patients are in the process of developing T2DM. However, the mechanisms of NAFLD and T2DM coexistence have not been fully elucidated. Considering that both diseases and their complications are of epidemic proportions and significantly affect the length and quality of life, we aimed to answer which of these diseases appears first and thereby highlight the need for their diagnosis and treatment. To address this question, we present and discuss the epidemiological data, diagnoses, complications and pathomechanisms of these two coexisting metabolic diseases. This question is difficult to answer due to the lack of a uniform procedure for NAFLD diagnosis and the asymptomatic nature of both diseases, especially at their beginning stages. To conclude, most researchers suggest that NAFLD appears as the first disease and starts the sequence of circumstances leading ultimately to the development of T2DM. However, there are also data suggesting that T2DM develops before NAFLD. Despite the fact that we cannot definitively answer this question, it is very important to bring the attention of clinicians and researchers to the coexistence of NAFLD and T2DM in order to prevent their consequences.
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Affiliation(s)
- Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Agnieszka Śliwińska
- Department of Nucleic Acids Biochemistry, Medical University of Lodz, 92-213 Lodz, Poland
| | - Józef Drzewoski
- Central Teaching Hospital of Medical University of Lodz, 92-213 Lodz, Poland
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Shift work and nonalcoholic fatty liver disease incidence among Chinese rail workers: a 4-year longitudinal cohort study. Int Arch Occup Environ Health 2023; 96:179-190. [PMID: 35989361 DOI: 10.1007/s00420-022-01913-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/10/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Occupational harmful factors, such as shift work, are attracting increasing attention as a potential cause of nonalcoholic fatty liver disease (NAFLD). In this study, we aimed to identify the association between shift work and NAFLD incidence in Chinese rail population. METHODS A cohort study was conducted among 14,112 rail workers for 4-year follow-up. Shift work frequency and other potential variables were recorded by questionnaires, including demographic, lifestyle, and occupation information. Besides, body mass index, blood pressure, fasting blood glucose, total cholesterol, triglyceride, alanine aminotransferase, and aspartate aminotransferase were measured by anthropometric measurement and blood test. Diagnosis of new NAFLD case was based on abdominal ultrasonography. Cox proportional hazards regression model was used to determine whether shift work has effect on occurrence of NAFLD. RESULTS The incidence of NAFLD was 30.43% in total subjects. After adjustment for possible confounders, the RRs of NAFLD were 1.069 (95% CI 0.998-1.146) and 1.179 (95% CI 1.059-1.312) in occasionally shift work group and frequently shift work group respectively, compared to the seldom shift work group. In stratified analyses, the RRs of NAFLD incidence linked to shift work exposure seems increase among female and elder. The results of three sensitivity analyses were similar with main analysis. CONCLUSIONS This research provided further evidence of positive harmful effect of shift work on NAFLD incidence in Chinese rail workers, particularly in frequently shift work population. The risk estimate of shift work on NAFLD was higher in female and elder.
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Kim Y, Chang Y, Ryu S, Wild SH, Byrne CD. NAFLD improves risk prediction of type 2 diabetes: with effect modification by sex and menopausal status. Hepatology 2022; 76:1755-1765. [PMID: 35514152 DOI: 10.1002/hep.32560] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/19/2022] [Accepted: 04/30/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS The effects of sex and menopausal status on the association between NAFLD and incident type 2 diabetes (T2D) remain unclear. We investigated the effect modification by sex and menopause in the association between NAFLD and T2D; also, the added predictive ability of NAFLD for the risk of T2D was assessed. APPROACH AND RESULTS This cohort study comprised 245,054 adults without diabetes (109,810 premenopausal women; 4958 postmenopausal women; 130,286 men). Cox proportional hazard models were used to estimate hazard ratios (HRs; 95% confidence intervals [CIs]) for incident T2D according to NAFLD status. The incremental predictive role of NAFLD for incident T2D was assessed using the area under the receiver operating characteristic curve, net reclassification improvement, and integrated discrimination improvement. A total of 8381 participants developed T2D (crude incidence rate/103 person-years: 2.9 premenopausal women; 12.2 postmenopausal women; 9.3 men) during median follow-up of 5.3 years. NAFLD was positively associated with incident T2D in all groups. After adjustment for potential confounders, the multivariable-adjusted HRs (95% CIs) for incident T2D comparing NAFLD to no NAFLD were 4.63 (4.17-5.14), 2.65 (2.02-3.48), and 2.16 (2.04-2.29) in premenopausal women, postmenopausal women, and men, respectively. The risks of T2D increased with NAFLD severity as assessed by serum fibrosis markers, and the highest relative excess risks were observed in premenopausal women. The addition of NAFLD to conventional risk factors improved risk prediction for incident T2D in both sexes, with a greater improvement in women than men. CONCLUSIONS NAFLD, including more severe NAFLD, is a stronger risk factor for incident T2D in premenopausal women than in postmenopausal women or men; protection against T2D is lost in premenopausal women with NAFLD.
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Affiliation(s)
- Yejin Kim
- Center for Cohort StudiesTotal Healthcare CenterKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea
| | - Yoosoo Chang
- Center for Cohort StudiesTotal Healthcare CenterKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea.,Department of Occupational and Environmental MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea.,Department of Clinical Research Design & EvaluationSAIHSTSungkyunkwan UniversitySeoulRepublic of Korea
| | - Seungho Ryu
- Center for Cohort StudiesTotal Healthcare CenterKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea.,Department of Occupational and Environmental MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea.,Department of Clinical Research Design & EvaluationSAIHSTSungkyunkwan UniversitySeoulRepublic of Korea
| | - Sarah H Wild
- Usher InstituteUniversity of EdinburghEdinburghUK
| | - Christopher D Byrne
- Nutrition and MetabolismFaculty of MedicineUniversity of SouthamptonSouthamptonUK.,National Institute for Health and Care Research Southampton Biomedical Research CentreUniversity Hospital SouthamptonSouthamptonUK
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Alam S, Raghav A, Reyaz A, Ahsan A, Ahirwar AK, Jain V, Agarwal S, Tripathi P. Prevalence of elevated liver enzymes and its relationship with type 2 diabetes mellitus in North Indian adults. Metabol Open 2021; 12:100130. [PMID: 34622192 PMCID: PMC8479470 DOI: 10.1016/j.metop.2021.100130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) also referred as metabolic as metabolic (dysfunction) associated fatty liver disease. Type 2 diabetes mellitus (T2DM) is a major cause in progression of NAFLD and non-alcoholic steatohepatitis (NASH). The aim of the present study is to assess the activity of liver enzymes in T2DM in North Indian population. Method This was a cross-sectional descriptive study clinic-based study in patients with T2DM. A total of 612 participants (226 healthy controls and 386 T2DM) were recruited. Body mass index (BMI), activity of liver enzymes including alanine and aspartate aminotransferase (ALT, AST) along with alkaline phosphatase (ALP) was measured. Fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) along with total protein (TP) and albumin were also measured. Quantitative variables were expressed as mean ± SD, while qualitative variables as frequencies (%). Pearson/Spearman correlation test, unpaired t-test, Chi-squared test was used to assess the correlation, association and significant differences between study groups respectively. A P-value of < .05 was set as statistically significant. The Statistical Package for Social Sciences (SPSS) ® Statistics, version 23 (IBM SPSS Statistics, Armonk, NY) was used to for analysis of data. Results The study was conducted on 386 T2DM patients, and out of 386 patients, 139 (36.01%) were male (P < .000) and 247 (63.98%) were female. The mean age of the T2DM patients was 46.4 ± 13.6 years, while healthy individuals have mean age of 39.2 ± 12.0 years (P < .000). It was observed that the activity of AST in T2DM is comparable with the healthy persons (P = .060). While the level of ALT, total bilirubin and ALP in T2DM is significantly higher compared to healthy control (P < .000). On average, 62.53% of T2DM subjects and 32% of participants of healthy subjects had abnormal liver enzymes activity. Conclusion The present study has revealed widely co-existent derangements in liver function tests (LFTs) in the diabetic population of North India. A detailed workup in such patients may be helpful in timely diagnosis and treatment. Moreover, early detection and management of abnormal liver parameters in T2DM would help minimize liver-related morbidity and mortality.
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Affiliation(s)
- Sana Alam
- Department of Biochemistry, Hamdard Institute of Medical Sciences and Research, New Delhi, 110062, India
| | - Alok Raghav
- Multidisciplinary Research Unit, Department of Health Research, Ministry of Health and Family Welfare, GSVM Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Alisha Reyaz
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Akif Ahsan
- Department of Biochemistry, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, 202002, India
| | - Ashok Kumar Ahirwar
- Department of Biochemistry, University College of Medical Sciences, New Delhi, 110095, India
| | - Vineet Jain
- Department of Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, 110062, India
| | - Saurabh Agarwal
- KPS Institute of Medicine, GSVM Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Prashant Tripathi
- Department of Biochemistry, GSVM Medical College, Kanpur, Uttar Pradesh, 208002, India
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