Abstract:
Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes for chronic
liver disease in Asians. It occurs more commonly in patients with type 2 diabetes mellitus (T2DM).
However, data on prevalence and associations of NAFLD among Sri Lankans with diabetes are lacking. The
main aim of this study is to investigate the prevalence and factors associated with NAFLD in a cohort of
diabetic patients.
Methods: Total of 233 patients with type 2 diabetes mellitus, followed up at a diabetes center in Southern
Sri Lanka, were recruited by convenience sampling method. Each of them underwent a detailed medical
history, physical examination, laboratory investigations and abdominal ultrasonography(USS). The
diagnosis of NAFLD was made according to the established criteria using USS.
Results: The overall prevalence of NAFLD based on USS was 62.6% with no significant gender difference.
Compared to USS, elevation in AST and ALT levels, based on NHANES III criteria, occurred only in 42% (98/
234). The patients with NAFLD (56.7 ± 8.9) were significantly younger and had higher BMI and waist
circumference, and raised AST and ALT than those without NAFLD. Binary logistic regression showed that
the use of pioglitazone, higher BMI, and waist circumference were independently and significantly
associated with NAFLD.
Conclusions: NAFLD is common in Sri Lankan patients with T2DM and central and global obesity are
significant associations. Use of pioglitazone seemed to be protective against the development of NAFLD.
These findings underscore the need for weight management as a preventive measure of NAFLD in T2DM
patients.
