The association between type 2 diabetes mellitus, hypertension & severity of fibrosis in patients with NAFLD

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) considered the most common chronic hepatic disorders on a global scale. In the context of non-alcoholic steatohepatitis (NASH), hepatic steatosis is associated with lobular inflammation and cellular apoptosis, which may culminate in fibrosis and cirrhosis.  As being highly frequent condition in patients with type 2 diabetes (T2DM) and hypertension, NAFLD the identification of patients with higher risk of developing the more severe fibrosis remains obscured in clinical practice.

Aim of the study: The aim of this study is to assess the severity of non-alcoholic fatty liver disease (NAFLD) in a sample of Iraqi patients using fibrsocan and correlate the severity of fibrosis with T2DM & hypertension  

Patients and methods: The present cross-sectional study encompassed 124 patients exhibiting clinical, laboratory, and imaging evidence of Non-Alcoholic Fatty Liver Disease (NAFLD)& who were hypertensive and or type 2 DM , who were recruited from the Gastroenterology Center at Al-Diwaniyah Teaching Hospital in Al-Diwaniyah, Iraq, over the duration from February 2023 to April 2024. The FibroScan (Fibroscan 530 compact, Echosense, Paris, France) was employed, and a highly trained gastroenterologist was responsible for the assessment of liver fibrosis and steatosis.

Results: Patients were distributed as following:  26 patients had Normal (Fibrosis score 0) accounting for 21.0 %; 44 patients had Mild (Fibrosis score 1) accounting for 35.5 %; 23 patients had Moderate (Fibrosis score 2) accounting for 18.5 % and 31 patients had Severe (Fibrosis score 3) accounting for 25.0 %. With respect of  hypertension & T2DM there was significant relation between diabetes mellitus and severity of fibrosis (p < 0.001) , but no significant relation between  hypertension and severity of fibrosis (p = 0.380) , as shown

Conclusion: A significant increasing degree of liver fibrosis as indicated by fibroscan technique was present among those  patients with NAFLD and T2DM .