RÉSUMÉ
Background: Type 2 diabetics appear to be at greater risk of Non-alcoholic Fatty Liver Disease (NAFLD) and certainly of fibrosis and cirrhosis development. Type 2 diabetes and NAFLD are more common than previously thought, especially in India. To find out if there is a connection between NAFLD and Cardiovascular Disease (CVD) in a large group of type 2 diabetics, the current study was designed. Aim: 1) To study the prevalence of NAFLD by USG in patients with type 2 diabetes mellitus. 2) To correlate NAFLD with coronary artery disease and coronary risk factors in patients with type 2 diabetes mellitus. Methods: This was an observational, cross-sectional, open-labeled, single-centric, parallel-design study conducted in the department of general medicine of a tertiary care hospital among patients with type 2 Diabetes Mellitus (DM). Results: Among the 120 patients that took part in the study, there were 69 NAFLD patients and 51 non-NAFLD patients. Individuals with NAFLD had a significantly longer mean diabetes duration. In the NAFLD group, the prevalence of hypertension, obesity, visceral obesity, and metabolic syndrome was greater. The NAFLD group had much worse glycemic control. Sr. HDL and Sr. Triglyceride levels were found to be greater in the NAFLD group, whereas Sr. LDL levels were found to be higher in the non-NAFLD group, and Total cholesterol levels were practically comparable in both groups. ALT and AST values were higher in NAFLD patients than in non-NAFLD patients. Conclusion: The prevalence of NAFLD increases dramatically in the presence of type 2 diabetes, with the majority of patients affected in the fourth decade of life. Obesity, hypertension, and dyslipidemia were considerably more prevalent with NAFLD compared to subjects without NAFLD.
RÉSUMÉ
Background: Critically ill (CI) patients, especially those requiring mechanical ventilation (MV) are at a higher risk of malnutrition, which in turn is associated with increased hospitalization and excess mortality. The modified Nutrition Risk in Critically Ill (mNUTRIC) score, a predictor of mortality, has not been validated adequately in CI Indian patients. Thus, this study evaluated the mNUTRIC score as a prognostic marker of morbidity and mortality in CI patients requiring MV. Materials and methods: This prospective observational study was performed, between January 2018 and June 2019, in the intensive critical care unit (ICCU) of the medicine department of a tertiary care hospital. A total of 250 patients aged above 12 years, admitted in ICCU, and requiring MV for >48 hours were included. Based on the data collected, mNUTRIC score was calculated and patients were classified as at low (0–4) and high (5–9) nutritional risk. Mortality was the outcome variable. Results: More than a quarter of patients had a high mNUTRIC score (28.4%) and the overall mortality was 35.6%. A significantly greater proportion of non-survivors had a high mNUTRIC score (p-value<0.0001). Likewise, the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, and mNUTRIC score (all p-values<0.0001) were significantly higher among the non-survivors than the survivors. On receiver operator characteristic (ROC) curve analysis, a cutoff value of >2 predicted mortality [area under the curve (AUC): 0.83; 95% confidence interval: 0.778–0.874] with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 80.9, 76.4, 65.5, and 87.9%, respectively. Conclusion: At a cutoff of >2, mNUTRIC score had high sensitivity and specificity in the prediction of mortality.