Clinicopathological profile of hepatic involvement in type-2 diabetes mellitus and its significance.

ABSTRACT

AIMS AND OBJECTIVES: Involvement of liver as an organ complication in Type 2 Diabetes Mellitus (T2DM) is known. Studies are few about their baseline parameters from our country. Study the disease burden and clinicopathological profile of hepatic involvement in T2DM, find the associations with known risk factors and thus try to identify simple markers of advanced disease. MATERIAL AND METHODS: A screened group of randomly selected 47 patients of T2DM without other liver diseases (viral, alcoholic, drug, autoimmune, etc.) was selected. Their clinical (age, sex, body mass index, family history, blood pressure), biochemical (transaminases, lipid profile), and hepatic ultrasonographic (USG) and histopathological (HPE) profiles were studied. Segregation was done according to the histological severity and duration of diabetes (< 5 yrs, 5-10 yrs, > 10 yrs). RESULTS: On histology, normalcy was maintained in 17%, only fatty change was present in 43%, nonalcoholic steatohepatitis (NASH) could be identified in 40% with more advanced disease in 23%. Prevalence of cirrhosis was low. Positive family history, hypertension, longer duration, female sex and increased body mass index were significantly associated with NASH; more advanced disease was associated with male sex only. Incident lipid profile and transaminases levels were non-contributory. In the early stage, USG detected abnormality correlated poorly with HPE. CONCLUSION: The burden of hepatopathy in T2DM is high; with improving cardiovascular mortality, a higher burden awaits us in the next decade or so. Naturally, it becomes imperative to the treating clinician for targeting this aspect of diabetic complication from the very beginning of therapy.