To investigate the etiologic factors of non-alcoholic fatty liver disease patients

Non-alcoholic fatty liver disease (NAFLD) is a common, potentially serious disease with an increasing incidence. NAFLD is associated with obesity, Diabetes Mellitus type 2, and hyperlipidemia (96). Non-alcoholic steatohepatitis (NASH) is a serious form of NAFLD, and it may progress to hepatic failure, cirrhosis, and hepatocelluler carcinoma. Insulin resistance is the most important etiologıc factor among many other factorsİn our study we aimed to investigate the etiologıc factors of NAFLD in our region. The age of total 112 patients ranged between 20-73 (mean age 43.8, mean age of male and female patients were 41.8 and 45.4, respectively). Patients diagnosed as fatty liver by abdominal ultrasonography and without any other liver disease and known diabetes mellitus were included the study. Patients with normal liver enzymes were intended as hepatosteatosis group and with disturbed liver enzymes were intended as steatohepatitis group. The etiologıc factors in our patients were detected as following; in 53 patients (47.3 %) obesity, 97 patients (86.6 %) hyperlipidemia, 47 patients (42 %) insulin resistance, 11 patients (9,8 %) newly diagnosed diabetes mellitus. Because of hıgh frequency of newly diagnosed diabetes mellitus (9,8 %), it should be reminded that patients with hepatosteatosis may also have impaired oral glucose tolerance test ( OGTT) or latent diabetes mellitus. There was a positive correlation between degree of hepatosteatosis and HOMA-IR values, and correlation got stronger as degree of hepatosteatosis increased. There was significant statistical correlation between Body Mass Index (BMI) and Insulin resistance. Mean values of AST, ALT, ALP, and GGT were 34.2+/-21.6, 54.3+/-40.1, 81.2+/-27.7, 49.1+/-39.05 respectively. Ratio of AST/ALT was <1 in all patients. Of the 112 patients, 30 patients (26.7 %) had more than two times greater levels of normal AST and ALT levels, and 14 patients (12.5) had more than three times greater levels of normal AST and ALT levels. In 13.3% of patients GGT level and in 10.7 % of patients ALP level were more than two times greater than normal. Comparement of AST, ALT, GGT, total bilirubine, direct bilirubine, indirect bilirubine, albumin and heıght between two groups were statistically significant (p< 0.05). There wasn't significant correlation in the comparement of other parameters (p<0.05). Hepatic biopsy was performed in only 1 patient and result of biyopsy was reported as cirrhosis secondery to steatohepatitis. In our study hepatosteatosis was more common in female, steatohepatitis was more common in male patientsThere is no effective treatment of NAFLD. Therefore early diagnosis of insülin resistance and diabetes mellitus type 2 and other reversible- treatable risk factors such as obesity, dislipidemia, physical inactivity is still important.