Comparison of Clinico-Biochemical and Transient Elastography Findings Among Diabetic and Non-Diabetic Patients with Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease. It is characterized by a wide range of symptoms like fatigue, pain, or dullness in the upper right quadrant of the abdomen or none at all. The risk factors linked to NAFLD are type 2 diabetes mellitus (T2DM), obesity, and genetic predisposition. In this study, the clinical, biochemical, and ultrasonography findings were compared in NAFLD patients with and without T2DM. The liver elastography (FibroScan) measured liver stiffness (LSM), and the liver fibrosis index 4 (FIB-4) were both significantly higher in diabetic patients. The controlled attenuation parameter (CAP) was not statistically significant when compared in the two groups. There was a significant negative correlation between FIB-4 and platelet counts in both groups; p = 0.006 in non-diabetics and p = 0.001 in diabetics. There was a significant positive correlation between FIB-4 and aspartate aminotransferase (AST) in the non-diabetic group only. The non-invasive diagnostic and prognostic markers of NAFLD that are LSM, and FIB-4 are more reliable than inflammatory markers. Though the dietary habits, anthropometric measurements, and physical activity were not different and did not pose risk factors in our population, we need to study the genetic and epigenetic factors in our population.