Assessment of fatty liver and its correlation with glycemic control in patients with type 2 diabetes mellitus attending Dessie Comprehensive Specialized Hospital, Northeast Ethiopia

Abstract

Objectives: The purpose of conducting this study was to assess fatty liver disease and its correlation with glycemic control in type 2 diabetes mellitus patients. In addition, evaluation of associated factors and correlation analysis between the fatty liver index and hemoglobin A1C level in patients with type 2 diabetes mellitus was another aim of this study. Methods: A hospital-based cross-sectional study was conducted among type 2 diabetes mellitus patients attending at diabetes clinic of Dessie Comprehensive Specialized Hospital located in south Wollo, Ethiopia. It was conducted from July to August 2021. The fatty liver index was calculated to assess fatty liver disease. Simple descriptive statistics, multivariate analysis, and an independent sample t-test were utilized for statistical analysis. Multiple logistic regression analysis was used to determine the associated factors of fatty liver. The p value < 0.05 was considered as statistically significant. Results: In this study, the mean ± standard deviation values of body mass index among type 2 diabetes mellitus patients were 25.82 ± 3.64, 28.04 ± 2.43, and 22.70 ± 2.62 in both fatty and non-fatty liver cases, respectively. In this study, the prevalence of fatty liver among type 2 diabetes mellitus patients was 58.4%. There was a significant positive correlation between the level of Hemoglobin A1C or glycated hemoglobin and fatty liver index (p value = 0.008, r = 0.35). The development of fatty liver was 4.6 times more likely among patients with type 2 diabetes mellitus who had insufficient physical exercise than sufficient exercise. Patients with insulin and oral hypoglycemic drugs were 0.8 folds less likely to have a fatty liver as compared to oral hypoglycemic drug treatment. Conclusion: The results of this study showed that the prevalence of non-alcoholic fatty liver disease was elevated among patients with type 2 diabetes mellitus who had higher levels of body mass index, waist circumference, triglycerides, glycated hemoglobin, and gamma-glutamyltransferase. Therefore, glycemic control, sufficient physical exercise, and insulin treatment may reduce the risk of fatty liver disease in patients with type 2 diabetes mellitus.

Prevalence of metabolic dysfunction-associated fatty liver disease and its association with glycemic control in persons with type 2 diabetes in Africa: a systematic review and meta-analysis

“…This review consisted of nine cross-sectional and one case control studies published between 2011 and 2023. The studies were conducted in 6 different Africa countries, with majority coming from Nigeria (n=3) [24–26], followed by Ethiopia (n=2) [27, 28], Morocco (n=2) [29, 30], and one each from Egypt [31], Ghana [32], and Sudan [33]. A total of 1667 T2D participants were involved, with the sample size ranging from 80 to 281 across studies.…”

“…The quality score across studies ranged from 8 to 3, with a mean score of 6.1. Majority (n=6) of the studies were of low risk of bias, having a score above 7 [25–28, 30, 32]. In contrast, four studies fell below a cut-off score of 5, indicating a higher risk of bias [24, 29, 31, 33].…”

“…Two articles assessed the association between MAFLD and HbA1c, with both identifying a significant positive correlation between these variables [26, 28]. The correlation coefficient recorded 0.27 in Afolabi et al’s study [26] and 0.35 in Abebe et al’s study [28].…”

“…Two articles assessed the association between MAFLD and HbA1c, with both identifying a significant positive correlation between these variables [26, 28]. The correlation coefficient recorded 0.27 in Afolabi et al’s study [26] and 0.35 in Abebe et al’s study [28]. As shown in figure 4 , the result of the meta-analysis indicates a weak positive correlation between MAFLD and HbA1c (r = 0.33, 95% CI: 0.18 – 0.47).…”

Prevalence, risk factors and liver-related complications of nonalcoholic fatty liver disease in Ethiopian HIV-infected patients: a cross-sectional study in a tertiary care center

“…Although there is no data regarding the population prevalence of NAFLD in Ethiopia, few hospital and institution based studies have tried to assess the prevalence of NAFLD in patients with diabetes. These studies found a higher prevalence of NAFLD ranging between 58.4 and 73% was found [6,7].…”