Characteristics of non-alcoholic fatty liver disease in Palestinian diabetics: A cross-sectional study

Authors

Wassiem Takhman, Department of Medicine, An-Najah National University, Nablus, Palestine
Mohammad A. Nour, Department of Medicine, An-Najah National University, Nablus, Palestine
Anas Merai, Department of Medicine, An-Najah National University, Nablus, Palestine
Lubna Saudi, Family and Community Medicine Department, An-Najah National University, Nablus, PalestineFollow
Mosab Maree, Department of Medicine, An-Najah National University, Nablus, Palestine. & Radiology Department, An-Najah National University Hospital, Nablus. Palestine
Ahmed Awad Ghanem, Department of Medicine, An-Najah National University, Nablus, Palestine. & Radiology Department, An-Najah National University Hospital, Nablus. Palestine
Jihad Hamaida, Department of Medicine, An-Najah National University, Nablus, Palestine. & Radiology Department, An-Najah National University Hospital, Nablus. Palestine
Basma Damiri, Drugs and Toxicology Division, An-Najah National University, Nablus, PalestineFollow

Abstract

This cross-sectional study was performed to identify the factors associated with non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) patients in Nablus, Palestine, and decrease the burden of liver diseases. Patients with T2DM who visited primary healthcare clinics in Nablus from January to April 2022 were invited [n=508] to participate. A face-to-face interview was conducted, and medical reports were used to collect the patient's details. The hepatic steatosis index (HSI) was calculated as an indicator of the possibility of the presence of NAFLD. Ultrasound was used to diagnose fatty liver disease (FLD) as mild, moderate, and severe. 399 Patients completed participation, with a mean age of 56.1±10.4 years; 56.1% were males, 91.2% had an HSI score ≥36, and 8.8% had an HSI score of 30-36. Moreover, 3.8% were diagnosed with mild FLD, 42.1% with moderate FLD, and 3.8% with severe FLD. Compared to patients without fatty liver disease, severe FLD patients were at higher risk of having increased cholesterol levels (OR=1.047), increased HSI (OR=1.32), and diabetic retinopathy (OR=7.074). Predictors for moderate FLD have increased cholesterol levels (OR=1.023), glycated hemoglobin (HbA1c) (OR=1.06), HSI (OR=1.21), and age (OR=1.071). Predictors for mild FLD have increased cholesterol levels (OR=1.02), HbA1c (OR=1.312), HSI (OR=1.102), and age (OR=1.047). Decreased levels of low-density lipoproteins were associated with decreased risk of mild (OR=0.982), moderate (OR=0.97), and severe (OR=0.955) FLD. Diabetes treatment regimen, the number of years diagnosed with diabetes, hypertension, high-density lipoprotein, and triglycerides levels were not associated with FLD. In conclusion, the prevalence of NAFLD among Palestinian T2DM patients was higher than the reported global prevalence. Several modifiable (weight, HbA1c, HSI score, total cholesterol, and low-density lipoprotein levels) and non-modifiable (age and diabetic retinopathy) factors were associated with NAFLD. This research recommends a screening program for the early detection of NAFLD among Palestinian people with diabetes using ultrasound.

Digital Object Identifier (DOI)

10.59049/2790-0231.1250

Recommended Citation

Takhman, Wassiem; Nour, Mohammad A.; Merai, Anas; Saudi, Lubna; Maree, Mosab; Ghanem, Ahmed Awad; Hamaida, Jihad; and Damiri, Basma (2023) "Characteristics of non-alcoholic fatty liver disease in Palestinian diabetics: A cross-sectional study," Palestinian Medical and Pharmaceutical Journal: Vol. 8 : Iss. 3 , Article 8.
Available at: https://doi.org/10.59049/2790-0231.1250