Non-Alcoholic Fatty Liver Disease and Its Relationship with Metabolic Syndrome Among the Adult Patients Attending in Rajshahi Medical College Hospital, Rajshahi, Bangladesh

Abstract

NSM Momtazul Islam, Md Khalilur Rahman, Mohammad Mahbubur Rahman Khan, Mohammad Hasan Tarik, Mohd Harun-or-Rashid, Md Jawadul Haque, Syed Mahbub Alam

Background: Metabolic syndrome describes the co-occurrence of central adiposity, hyperglycemia, hypertension, lipid abnormalities and other metabolic changes that increase risk of cardiovascular, cerebrovascular, renal diseases. This multi-system condition has adverse effects on many organs, the liver being one of them. Non-alcoholic fatty liver disease appears to be the hepatic manifestation of metabolic syndrome, and is increasingly recognized as a major contributor to the burden of chronic liver disease world-wide. Metabolic syndrome and non-alcoholic fatty liver disease appear to have a common pathogenesis, arising from insulin resistance, central adiposity and chronic low grade inflammation.

Objective: The aim of the study is to find out the occurrence of NAFLD and metabolic syndrome among the patient attending in RMCH.

Materials and Methods: This is a cross sectional descriptive study which was conducted in the Department of Medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh. 250 patients age above 20 years nonalcoholic both male and female were included for the study. All patients were interviewed by structured questionnaire. Statistical analysis was carried out by using the Statistical Package for the Social Sciences (SPSS) software version 23.0 for windows (SPSS Inc, Chicago, Illinois, USA). Continuous data are expressed as the mean ± standard deviation (SD) and categorical variables are expressed as percentages. Pearson correlation coefficient test and unpaired t-test were used for this study. For all statistical tests, p-value is less than 0.05 was considered as statistically significant.

Results: Among 250 respondents a total of 67(26.8%) cases were diagnosed as metabolic syndrome and out of the 67 metabolic syndrome patients 23(34.33%) were male and 44(65.67%) were female. Out of the 23 male metabolicsyndrome patients 9(39.13%) were diagnosed as NAFLD and out of the 44 female metabolic syndrome patients 16(36.36%) were diagnosed as NAFLD. Among the 250 respondents 53 (21.2%) cases ultarsonographically diagnosed as NAFLD and showed 41(77.36%), 11(20.75%) and 1(1.89%) of cases had grade I, II, and III fatty liver respectively. Out of the 53 NAFLD patient’s 25 patients were presented with metabolic syndrome and 28 patients were without metabolic syndrome. Patients of NAFLD with metabolic syndrome presented with high fasting plasma glucose level in 19(67.80%) cases, hypertensive in 17(68%) cases, high triglyceride in 17((68%) cases, low HDL in 16(64%) cases, waist circumference high in 18(72%) cases. The difference was significant for fasting plasma glucose, blood pressure, triglycerides, high-density lipoprotein and waist circumference (p<0.05) between metabolic syndrome and non-metabolic syndrome patients.

Conclusion: From the study, it can be concluded that the proportion of NAFLD significantly higher in metabolic syndrome patients compare to non-metabolic syndrome patients and metabolic syndrome is higher in female compare to male. So early diagnosis of metabolic syndrome suspected cases and ultrasonographic detection of NAFLD would help not only modifying the disease course but also delaying its complication.

PDF