Prevalence of Non-alcoholic Fatty Liver Disease among Patients with Diabetes Mellitus Attending Primary Health Care Centers in Bahrain

Abstract

Objectives: To identify the prevalence of non-alcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes mellitus (T2DM) in Bahrain and to assess the risk factors for the same. Methods: This retrospective cross-sectional study investigated a random sample of patients who were treated for T2DM during 2018 at non-communicable disease clinics in primary health centers in Bahrain. Cases of 382 patients who underwent abdominal ultrasonography were selected for the study. The collected patients' data were statistically analyzed. Prevalence of NAFLD among T2DM patients and the possible risk factors were assessed. Results: The mean age of the study population (N = 382) was 59.0±12.0 years. The majority (61.5%) were women. Hypertension (57.9%) was the most prevalent associated condition. Most patients were either overweight (30.5%) or obese (58.3%). Fatty liver was found in 68.1% patients based on ultrasound imaging. Elevated alanine aminotransferase was found in 75 (21.0%) out of 357 (93.5%) patients who were tested for the same. The significant risk factors identified for fatty liver were female (p = 0.013), high body mass index (BMI) (p < 0.001), high waist circumference (p = 0.011), and high triglyceride levels (p = 0.043). Binary logistic regression identified BMI as an independent risk factor for fatty liver (p = 0.005). Conclusions: The prevalence of NAFLD among patients with T2DM in Bahrain is high, and comparable to the levels reported in other studies. Female and high BMI, waist circumference, and triglyceride level are risk factors for NAFLD, while BMI is an independent risk factor.