ASSOCIATION OF LIFESTYLE AND METABOLIC RISK FACTORS WITH GRADES OF FATTY LIVER IN NON DIABETIC NAFLD PATIENTS.

Abstract

Introduction: Non Alcoholic Fatty Liver (NAFL) is a public health problem in India.
Objectives: To study association of lifestyle and metabolic risk factors with grades of fatty liver
(FL). Materials and Methods: NAFL (n=160) cases constituted the study group, FL was
diagnosed by ultrasound of abdomen. Anthropometric and biochemical parameters were
recorded. Lifestyle and metabolic risk factors were compared in different grades of FL.
Results: Grade 1 FL was present in 69 % and grade 2 in 31 % of subjects. The prevalence of
lifestyle risk factors were higher in grade 2 FL versus grade 1 FL but were non-significant:
Low physical activity (57.1 % versus 55.8 % ), snack intake (87.7 % versus 81.0 %) ,
saturated fatty acid >8% of total calories (18.3 % versus 16.2 % ), edible oil >25 g for males and
>20 g for females (93.8 % versus 90.9 % ) alcohol intake ( 81.6 % versus 78.3 %). The
prevalence of metabolic risk factors were significantly higher in grade 2 FL versus grade 1 FL:
BMI > 25 ( 87.7 % versus 61.2% ), waist circumference ( 75.5% versus 45.0 %) , WHR (91.8
% versus 76.5%), IGT (24.4 % versus 6.3%),triglycerides ( 53.0 % versus 28.8 % ), Metabolic
Syndrome (MetS) (46.9 % versus 22.5 %). On univariate regression analysis, grade 2 FL
showed positive association with metabolic factors [BMI > 25 [OR (95% CI) [ 11.38 (1.46-
18.37), waist circumference [ 3.7 (1.77-7.97), WHR [ 3.4 (1.13-4.47), IGT [ 4.8 (1.76-13.16),
high serum triglycerides [2.7 (1.39-5.59) and MetS [3.0 (1.48-6.22). Conclusions The
worsening grades of fatty liver are associated with metabolic risk factors and should initiate
workup of patients to avoid progression of NAFL to severe forms.