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Background: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in the United States and other industrialized countries, many study has identified NAFLD as a risk factor not only for premature coronary artery disease and cardiovascular events, but also for early subclinical abnormalities in myocardial structure and function. Aim of this study was to the presence of NAFLD in patients with Ischemic Heart Disease (IHD) and Relation of NAFLD with other risk factors of IHD.Methods: The study group consisted of 150 patients that comply with inclusion criteria and selected of 100 consecutive patients who underwent coronary angiographies. Coronary artery disease was defined as a stenosis at least 50% in at least one major coronary artery. Fatty liver was diagnosed by abdominal ultrasonography (4 stages: Grades 0, 1, 2 and 3). Statistical evaluations were performed using T test, Chi- square test.Results: The present study was done in 100 patients of coronary artery disease divided into two groups i.e. Non NAFLD group n= 62 (62%) and NAFLD group n= 38 (38%). The present study shows that the prevalence of NAFLD was highest (86.8%) in more than 40 years of age group. The present study shows that the prevalence of NAFLD was more in males (84.2%) as compare to females (15.8%). The present study also shows significantly high incidence of metabolic syndrome in patients with NAFLD (23.7%) as compared to Non-NAFLD (3.2%) patients with Coronary Artery (CAD).Conclusions: The presence of fatty liver and its severity should be carefully considered as independent risk factors for IHD. The study results suggest the synergistic effect in between fatty liver and deranged lipid profile for developing IHD. Abdominal ultrasonography may provide valuable information about IHD risk assessment.
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Diabetic ketoacidosis (DKA), Acute Pancreatitis and Hypertriglyceridemia are an unusual and infrequent presentation of Diabetes. Hypertriglyceridemia leading to acute pancreatitis is most commonly encountered in poorly controlled Diabetics. In this case report we have described a young Type 1 Diabetic female presenting with Diabetic Ketoacidosis and hypertriglyceridemia induced Pancreatitis (HTIP). The proposed mechanism is triglyceride excess is hydrolyzed by pancreatic lipase resulting in the formation of excess free fatty acids. Excess free fatty acids cause acinar cell injury and capillary leakage in pancreatic vascular beds. Hyperlipasemia frequently occurs in DKA without an underlying acute pancreatitis. Half of the patients with HTIP have falsely low or normal serum Amylase. Imaging is required to confirm the diagnosis of pancreatitis. So, high degree of suspicion is required to diagnose this unusual presentation of diabetes.
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Background: Individuals with type 2 diabetes display features of low-grade inflammation. Mediators of inflammation such as IL-6 have been proposed to be involved in the events causing as well as progression of diabetes. Diabetic nephropathy is one of the commonest causes of chronic kidney failure throughout the world. Although diabetic nephropathy is traditionally considered a non-immune disease, accumulating evidence now indicates that immunologic and inflammatory mechanisms play a significant role in its development and progression.Methods: This cross sectional study was conducted in the department of medicine, UPUMS, Saifai. The study was conducted from June 2018 to February 2019. A total of 80 type 2 diabetes patients were included in the study. After informed consent, patients were recruited. FBS, PPBS, HbA1C, 24 Hrs Urinary protein and interleukin-6 levels were measured. The data was analysed using SPSS 23. Pearson co relation co efficient was determined between IL -6, HbA1c and Urinary protein.Result: A total of 80 type 2 diabetes patients were studied. The study subjects were divided into 3 groups based on the urinary protein level into normo-albuminuria, Micro- albuminuria and macro- albuminuria. FBS, PPBS, HBA1c, 24 Hrs Urinary protein and Interleukin – 6 were significantly associated with proteinuria (p<0.001). Urinary protein was positively correlated with IL-6 (R2=0.57, p<0.01). The blood glucose was positively correlated with IL-6 (R2=0.413, p-0.01).Conclusion: Raised IL-6 levels in diabetics revealed the presence of inflammation. Our study showed positive correlation between IL-6, HBA1c and Urinary protein.
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Background: Diabetes Mellitus comprises a group of metabolic disorder leading to hyperglycaemia. Vitamin D deficiency plays a role in Type 2 Diabetes Mellitus pathogenesis. Vitamin D appears to affect several metabolisms that have been associated with coronary artery disease. Vitamin D level has been recently considered as an adjustable risk factor of cardiovascular diseases, in individuals with type 2 Diabetes.Methods: This case control study was conducted in the Department of Medicine, UPUMS. 100 diabetic individuals with low Vitamin D level were taken as cases and 100 diabetic individuals with normal vitamin D level as control. History and examination with necessary investigations were done. Patients with positive history were subjected to investigations to diagnose CAD.Results: The proportion of case and controls had no significant difference in age distribution. The risk of coronary artery disease was 2.76 times higher among diabetes mellitus patients with vitamin D deficiency (1.36-5.59). The risk of CAD was adjusted for various risk factors (age, sex, hypertension, smoking, physical activity, and lipid profile) Odds ratio was found to be 2.8 (95% CI-1.19-6.94, p-0.018).Conclusions: Vitamin D deficiency among diabetes patients was found to be an independent risk factor for CAD after adjusting other risk factors emphasizing that vitamin D can be a potential risk factor for development of coronary artery disease.