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The association of risk factors in the development of non-alcoholic fatty liver disease (NAFLD) in Filipino patients with type 2 diabetes mellitus in a tertiary center .


Jovie Joy Manuel,
Elaine Palugod,
Juliet Cervantes,
Mercy Go-Santi,
Joselynna Quimpo,
Gabriel Jasul

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Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Internal Medicine
Six times a year (6x/year)
Publication Date
May-June 2007


BACKGROUND: Non-alcoholic Fatty Liver Disease (NAFLD) includes a spectrum of liver damage, ranging from simple, bland steatosis, which is usually associated with a benign prognosis, to nonalcoholic steatohepatitis (NASH), which has the potential to progress to cirrhosis and its inherent complications of liver failure and liver cancer. It is reported to be prevalent among patients with Type 2 Diabetes Mellitus.

OBJECTIVES: (1) To determine the association of the risk factors in the development of non-alcoholic fatty liver disease, in Filipino patients with Type 2 Diabetes Mellitus; (2) To assess the correlation between the severity of ultrasonographic hepatic steatosis and degree of glucose control, dyslipidemia and obesity; (3) To observe the hepatic markers particularly the transaminases in patients with Type 2 diabetes mellitus with obesity and or dyslipidemia.

METHODS: One hundred forty se-ven diagnosed Type 2 diabetes without history of alcohol intake >30g/week in men and 20g/week in women underwent history and physical examination and anthropometric measurements. BMI was used to estimate overall adiposity. Fasting blood samples were collected for measurement of liver function (GGT, ALT, AST, CHON, Bilimbin, ALP), and hepatitis profile (HBsAg, Anti-HBs, Anti-HCV) to note those with concurrent liver diseases. Lipid profile, were also obtained to identify diabetic patients with dyslipidemia; fasting blood sugar, and HbAlc defined the glycemic control in its relation to the presence of probable NAFLD. All subjects underwent ultrasonography of the liver using one ultrasound machine, performed by one radio-technologist, and read by only one sonologist. Presence of fatty liver was noted and reported as mild, moderate and severe.

RESULTS: Features of NAFLD seen in the subjects in this study include absence of symptoms referable to the liver, elevated transaminases ( ALT at 15 percent, AST at 13 percent, with ALT/AST > lat 12 percent) and with features of metabolic syndrome. Statistatically, there is no association of the ALT/ AST > 1 (probable NAFLD) among the Type 2 DM subjects with dyslipidemia, obesity and metabolic syndrome. Sonographic NAFLD, however, showed that there is a significant association of fatty liver and obesity at 69% with a p value of

CONCLUSION: There is a close link of hepatic steatosis to T2DM patients who are obese. Elevated ALT was correlated in the development of fatty liver. Type 2 Diabetes Mellitus associated with NAFLD has the potential to progress to cirrhosis and its inherent complications of liver failure and liver cancer and thus make an important endocrine health problem. (Author)


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