Evaluation of NON-alcoholic fatty liver disease (NAFLD) TYPE 2 diabetes patients: treatment management and awareness

INTRODUCTİON AND AİMS: In our study, we aimed to show examine the management and treatment plans of patients with NAFLD and type 2 DM by calculating the hepatosteatosis stage detected on USG and blood glucose, HBA1c and FIB-4 scores (AST, ALT, PLT, age). When NAFLD was detected, concomitant diseases, presence of microvascular complications of diabetes (retinopathy, nephropathy, neuropathy, diabetic foot) were recorded and general approaches planned for the patient were examined. METERİAL AND METHODS: The study included 443 patients over the age of 18 who had Abdominal Ultrasound between January 2018 and February 2021, among the patients followed up in Dokuz Eylül University Endocrinology outpatient clinic with the diagnosis of Type 2 Diabetes. The HS stages detected on USG of the patients were grouped as Grade 1-2-3. Demographic and laboratory characteristics of the patients were examined and the groups were compared. RESULTS: The mean age of the patients was calculated as 54.74±11.2 (23-86). Of the patients, 224 (51.6%) were female and 219 (49.4%) were male. The mean duration of diabetes was 9.42±7.33 years. Grade 1 hepatosteatosis was found in 115 (26%) of 443 patients, grade 2 hepatosteatosis in 235 (53%) and finally grade 3 hepatosteatosis in 93 patients (21%). Considering the HS stages, there was no significant difference between the groups according to gender. There was a significant difference between HS stages and BMI. (p:0.000). Metformin was used significantly more in patients with HS stage 1 (p: 0.007). When hepatosteatosis stages and AST, ALT, GGT, triglyceride and hemoglobin values were compared, there was a statistically positive correlation between the groups, while a negative correlation was found between HS stages in terms of HDL levels. The groups were similar in terms of duration of diabetes, diabetes complication rates and durations. After the detection of HS, 229 patients (51.7%) were followed up without treatment, and the most applied approach was to get a dietitian's opinion (n:149 33.6%) in all groups. However, in the cases in which pioglitazone was started, most cases with grade 3 HS were 22 patients. There was a statistically significant difference between the HS groups compared to starting pioglitazone (p:0.002). When the FIB-4 score of the patients was calculated, it was seen that the highest number of patients were in the low-risk group. Obtaining the opinion of a dietitian in low-risk groups was found to be significantly different (p: 0.002). There was no significant difference between FIB-4 scores and HS stage. CONCLUSİONS: NAFLD prevalence is high in type 2 DM patients and HS stages vary according to different variables. There was no significant difference between FIB-4 scores and HS stage. KEYWORDS: Hepatosteatosis, Type 2 Diabetes Mellitus, Nonalcoholic Fatty Liver Disease, Ultrasonography