Exploring the role of type II diabetes mellitus and obesity as risk factors in patients afflicted with fatty liver disease

Abstract

Fatty Liver Disease (FLD) frequently coexists with Type 2 Diabetes Mellitus (T2DM) and
Obesity, often considered as a manifestation of the metabolic syndrome. FLD encompasses a
spectrum of presentations, ranging from simple steatosis to steatohepatitis and cirrhosis, with a
staggering prevalence of 75% among T2DM patients. Overweight/obesity and insulin resistance
(IR) are closely associated with FLD. Noninvasive assessment and disease staging rely on factors
such as age, sex, lipid profile, BMI, and diagnostic modalities like Steatositis scores and Stiffness
values, aiding early FLD detection and fibrosis prediction. The management of FLD in the
context of T2DM and Obesity primarily targets improving IR and glycemia, serving as a key
treatment approach. This study aimed to investigate the relationship between T2DM and Obesity
as risk factors for Fatty Liver Disease patients. A cross-sectional study was conducted from
November 2022 to March 2023, involving 90 patients aged ≥30 years with a history of FLD,
comprising 45 with T2DM and 45 with Obesity, selected from the Gastroenterology and
Hepatology Teaching Hospital in Al-Najaf City, Iraq. All patients were diagnosed by physicians,
and Fibro Scan results were used for examination and assessment. The FLD patient group was
categorized into subgroups based on the presence of T2DM and Obesity. Fasting blood glucose
and lipid profiles were measured using the colorimetric method. The study findings revealed no
statistically significant difference in mean age between the two groups. However, significant
differences were observed between the T2DM and Obesity groups in terms of mean BMI,
Steatositis score, Stiffness, Fasting blood sugar, triglycerides, total cholesterol, LDL, and HDL.
Steatositis score demonstrated a significant correlation with BMI (r=0.286, p=0.006), a negative
association with serum TG level (r=-0.07, p=0.01), and a positive correlation with TC level
(r=0.80, p=0.0001). Furthermore, the steatositis score positively correlated with Stiffness level
(r=0.387, p=0.0001). This study underscores the elevated prevalence of FLD in patients with
T2DM and Obesity, shedding light on the risk factors associated with FLD. It emphasizes the
need for further large-scale studies to assess the impact of lifestyle modifications, including
physical activity and dietary changes, on FLD and glycemic control status.