Endocrine Abstracts

Among individuals who came for master health check up to Apollo hospitals, Chennai between June 2011 to November 2011, 750 patients were recruited based on the inclusion and exclusion criteria. Those who showed fatty liver on ultrasonography were compared with those who had normal liver parenchyma. People with acute medical illness, known hepatic disease, known renal disease, people who consume excessive alcohol (>20 g/day), patients on medications that cause hepatotoxicity (such as estrogens, corticosteroids, amiodarone, valproate; at present or within the last 2 years) were excluded.

Our study showed 44% prevalence of fatty liver, which is much higher than those reported in last decade and certainly indicates an upward trend in increasing prevalence of FLD (earlier studies have shown prevalence anging from 10 to 22%). In this study FLD was present mainly in the middle-aged group with peak occurrence around 40–50 years with mean age at presentation being 47±11 years. Of them FLD was more common in men and this might be due to higher waist–hip ratio in men as compared to women, which is an indicator of central obesity and insulin resistance. We also found that fatty liver was undoubtedly associated with high BMI, increased waist circumference and WHR. Eight percent of the patients with FLD were either overweight or obese (49 and 31% respectively). As increased ALT has been reported to be positively associated with FLD, we also found that 30% of patients with FLD had elevated AST (>35 U/l) and ALT (>45 U/l) with the mean ALT greater than AST (44±32 vs 34±20). Seventy-two percent had ALT: AST ratio greater than the reverse ratio in FLD group (22%). Also, 76% of FLD group were either diabetic (36%) or pre-diabetic (40%) with only 24% being normal. The mean fasting and 2 h postprandial blood sugar levels in FLD patients were markedly higher than the control group (122±45 and 167±83 respectively). In this study, though the occurrence of hypertension was not significant, there was significant increase in the mean systolic BP in FLD patients (130.37±16.59). Seventy-three percent of our patients with FLD had metabolic syndrome. This is higher than that reported in a study conducted in South India. When compared to the last decade, the overall prevalence of FLD is progressively increasing in India in parallel with the increasing prevalence of T2DM, obesity and metabolic syndrome.