Cardiovascular Morbidity in Diabetic Non-Alcoholic Fatty Liver Disease (NAFLD) Using NAFLD Fibrosis Score as an Early Indicator

Abstract

Objective: Rising prevalence of non-alcoholic fatty liver disease (NAFLD), its high incidence in diabetic patients, and global diabetes prevalence, underline the need to identify comorbidities in these patients impacting their quality of life and mortality.NAFLDis associated with increased risk, prevalence, and complications of cardiovascular diseases in diabetic and non-diabetics alike. The study aimed to establish a relationship between noninvasively assessed cardiovascular morbidity and NAFLD fibrosis score (NFS) in type 2 diabetes mellitus with NAFLD. Material and Methods: After ethical approval, the study was conducted (n=100) on patients <60 years of age, havingtype 2 diabetes mellitus, and no existing cardiovascular disease. All patients underwent anthropological and routine investigations, two-dimension (2D) echocardiography, and ultrasonographic confirmation of fatty liver disease. NAFLD was ascertained based on patient history and investigations. Findings of cardiovascular evaluation on 2D-echocardiography were assessed with reference to the NFS. Results: Median age of participants was 53.5 years. Body mass index (p<0.001), right carotid intima-media thickness (p=0.0124), and left ventricular dysfunction (p=0.0024) showed a significant association with NAFLD. The presence of both left ventricular diastolic dysfunction and significant variation of carotid intima-media thickness among mild, moderate, and severe NFS groups (p=0.0049) was observed. Patients with moderate-severe NFS had 6.38 times more risk of developing cardiovascular morbidities. Conclusion: In patients with type 2 diabetes and NAFLD, the NFS helps to identify those at high risk of cardiovascular disease, and patients needing further investigation. It provides clues on how non-invasive cardiovascular markers can be used in detecting cardiovascular morbidities.