Prevalence of primary non-alcoholic fatty liver disease in black africans with type 2 diabetes at Kenyatta National Hospital

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is increasingly being recognized as a common disease in syndromes thought to have a patho-physiological basis in Insulin Resistance (IR), especially in patients with type 2 diabetes. There is an associated risk of progressive liver disease contributing to morbidity and mortality in such patients. Prevalence of this disease in Kenyans with type 2 diabetes remains unknown. This study aimed to determine the ultrasonographic prevalence of NAFLD in type 2 diabetics and correlate this with other known predisposing factors. Methods: This was a hospital-based cross-sectional study that evaluated 326 type 2 diabetic patients (47±7 years) who were insulin-naïve and on treatment with Oral Hypoglycemic Agents (OHAs), and with no history of alcohol consumption. Anthropometric measurements of Body Mass Index (BMI), Blood Pressure (BP) and Waist Circumference (WC) were taken. Abdominal (hepatic) ultrasonography, Lipid Profile Tests (LPTs) and Liver Function Tests (LFTs) were performed. Data was recorded, entered into a data base and analyzed using statistical package SPSS 17.0 program. Results: 34.4% (n=112) of study subjects had NAFLD on Ultrasound (U/S) (95% CI of 29.3%-39.8%), the most common grade being mild (n=67), followed by moderate (n=37) and severe (n=8). Deranged LFTs, obesity, dyslipidemia and hepatomegaly were significantly associated with NAFLD. Conclusion: There was a high prevalence of NAFLD in study subjects, which was significantly associated with deranged LFTs, obesity, dyslipidemia, and hepatomegaly