Baseline Values of Nonalcoholic Fatty Liver Disease Scores and Its Risk Assessment in Patients with Type 2 Diabetes Mellitus

Abstract

Introduction: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing and is fueled by a twin-epidemic of obesity and diabetes mellitus in India. The objective of the study was to estimate various noninvasive NAFLD scores (NINS) for the baseline risk-assessment of NAFLD in patients with type 2 diabetes mellitus (T2DM). Methods: An observational, cross-sectional, open label, study of investigator-rated NINS was conducted ensuring adherence to relevant ethical standards. Results: In a 3-month period, 29 patients with T2DM were enrolled (age [mean ± SD]: 55.8 ± 9.72 years; men [n, %]: 18, 62%). One patient (3.45%) by fibrosis-4 index (cutoff for advanced fibrosis ≥2.67) and by AST to platelet ratio index (cutoff ≥0.98); 2 (6.90%) by NAFLD fibrosis score (cutoff ≥0.676); 20 (69%) by body mass index (BMI), AST to ALT ratio, and DM score (BARD; cuff-off ≥2); and 27 (93.10%) by BMI, age, ALT, triglyceride score (cutoff ≥1) indicated high risk for advanced hepatic fibrosis. Only the BARD score (median [min-max]: 3 [1.4]) was elevated above the cutoff values while other scores were below cutoff values. The study failed to demonstrate any correlation between age, gender, anthropometric and metabolic parameters, and NINS. Conclusion: While this study did not demonstrate significant elevation of NINS, scores were found be elevated in some T2DM patients and they may be at high risk of advanced liver fibrosis. Further well-designed studies in this domain are required for early detection, management, and reducing the burden of liver disease in Indian patients with diabetes.