Introduction: In many Western countries, non-alcoholic fatty liver disease (NAFLD) is now surpassing viral hepatitis as the primary cause of chronic liver disease and hepatocellular carcinoma (HCC). In India, the current high burden of NAFLD is likely to rise further in the future. Given the significant prevalence of NAFLD in the community, identifying those at risk of developing liver disease is critical in order to simplify referral and advice effective management. Thus, the present study was carried out with the aim to diagnose Non-alcoholic fatty liver disease based on ultrasound and study its clinical profile in patients attending outpatient clinic and inpatients in a tertiary care hospital in Central India.
Material and Methods: This observational study was carried out in the Department of Medicine, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, after approval by Institutional Ethics Committee. 100 consented patients,>18 years of age presenting to the OPD and IPD of the hospital and suspected and later diagnosed as NAFLD were included in the study using a proforma, ultrasonography and investigations. Data was collected, compiled and analysed using SPSS 22.0 (trial version).
Results: 68%, 27%, 5% cases were diagnosed as grade I, grade II and grade III fatty liver respectively. The mean age was 47.07\(\pm\)11.95 years. Female preponderance was observed (55%). Abdominal pain (55%), fatigue (73%) and dyspepsia (48%) were the dominant symptoms. 51% patients had increased waist circumference (mean =87.06\(\pm\)10.46 cm). Mean BMI was 26.77+4.01 kg/m2. 46% were pre-obese and 15% were obese (BMI >30). Majority of Grade III fatty liver (60%) were diabetics. Mean values of impaired fasting blood sugar in grade I, II, III were 109.6\(\pm\)45.02, 117.52\(\pm\)56.93, 138.20 \(\pm\)53.31 mg/dl and when compared was statistically significant (p<0.05).29% patients had hypertension (\(\geq\)130/85 mmHg. 18% patients had high bilirubin levels. Deranged AST (46.48\(\pm\)27.30) and ALT (57.51\(\pm\)52.10) were found in greater percentage of patients (p value <0.001, <0.001 respectively) and had positive co-relation (r+0.36 and r+0.43). Hypercholesterolemia (>200mg/dl) was found in 46% patients. Mean cholesterol level in grade I, II and III was 192.71\(\pm\)43.43, 210.37\(\pm\)44.11 and 277.34\(\pm\)34.06; when compared it was found to be statistically significant (p< 0.01) with positive co-relation (r+0.39).Hypertriglyceridemia (>150mg/dl) was present in 60% cases. The mean triglyceride level in grade I, II and III was 160.46\(\pm\)51.28, 211.00\(\pm\)111.432 and 240.14\(\pm\)174.111 mg/dl respectively and when compared was statistically significant (p<0.05) with positive co-relation (r+0.29). Low HDL was present in 71% of patients. HDL cholesterol had a negative co-relation (r-0.17). In the present study mean LDL was 119.66+31.11 mg/dl and elevated LDL (>130mg/dl) was found in 29% of patients. Elevated VLDL was seen in 36% of patients with mean of 30.496+10.33 mg/dl.
Conclusion: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease in both the developed and developing worlds. It is emerging as a major public health problem. The present study throws light on the clinical spectrum of the disease. Early detection and treatment is of utmost importance in preventing this disease from emerging as a new epidemic globally.
