Correlation between Liver Fat Indices and Ultrasonography to Determine Non-alcoholic Fatty Liver Disease among Diabetic Patients in Sri Lanka

Abstract

Objectives: Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) strongly coexist as they share common pathophysiological conditions. Several non-invasive, patient-friendly, and cost-effective liver fat indices have been introduced recently to diagnose NAFLD at an early stage. This study aimed to establish the correlation between ultrasonography and liver fat indices (fatty liver index [FLI] and hepatic steatosis index [HSI]) to determine NAFLD among known T2DM patients. Material and Methods: A cross-sectional study was conducted using one hundred newly diagnosed type 2 diabetic patients attending the diabetic and endocrinology clinic at the Colombo South Teaching Hospital, Kalubowila, Sri Lanka. An interviewer-administered questionnaire was used to collect socio-demographic data and anthropometric measurements. Ultrasound scans were performed to diagnose and stage fatty liver. Biochemical investigations included aspartate amino transferase, alanine aminotransferase, gamma-glutamyl transferase triglyceride analysis. Scores for the liver fat indices were calculated using collected data and correlations between the variables were statistically analysed using the statistical software, SPSS version 23.0. Descriptive statistics, chi-square tests, Independent t-tests and Pearson correlation were used in the data analysis. Results: The incidence of NAFLD among T2DM was 82%. There was a statistically significant correlation (P < 0.05) between NAFLD diagnosed by ultrasonography and HSI. There was also a statistically significant correlation (P < 0.001) between NAFLD diagnosed by ultrasonography and FLI, and there was a statistically significant difference between FLI among participants with no fatty liver compared to participants with ≥ grade 2 fatty liver (P < 0.001. Conclusion: The current study showed that both FLI and HSI can be used as markers for the early diagnosis of NAFLD in T2DM patients.