Proportion of Non-Alcoholic Fatty Liver Disease (NAFLD) and Its Risk Factors Among Diabetic Patients Attending a Diabetic Clinic at a Tertiary Care Centre in Rishikesh, Uttarakhand: A Cross-Sectional Study

Reg ID: 28

Abstract

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common chronic liver disease worldwide and is closely linked with Type 2 Diabetes Mellitus (T2DM). Individuals with diabetes are at increased risk of hepatic steatosis, fibrosis, cirrhosis, and hepatocellular carcinoma. Despite the rising burden of metabolic diseases in India, region-specific data from Uttarakhand remain limited, particularly using non-invasive diagnostic modalities such as FibroScan with Controlled Attenuation Parameter (CAP).

Aim: To estimate the proportion and determine the risk factors of NAFLD among diabetic patients attending a tertiary care centre in Rishikesh, Uttarakhand.

Methods: A hospital-based cross-sectional study was conducted from December 2024 to May 2025 at All India Institute of Medical Sciences, Rishikesh. A total of 330 T2DM patients aged ≥30 years were enrolled using consecutive sampling. Data were collected through structured interviews, anthropometric assessment, biochemical investigations, and FibroScan. NAFLD was defined as CAP >238 dB/m, and liver fibrosis as liver stiffness measurement (LSM) >7.0 kPa. Statistical analysis was performed using SPSS version 25. Descriptive and inferential statistics, including independent t-test, Mann–Whitney U test, and Chi-square test, were applied. A p-value <0.05 was considered statistically significant.

Results: The proportion of NAFLD among diabetic patients was 60% (198/330). Participants with NAFLD had significantly higher mean body weight (p=0.001), body mass index (p<0.001), and waist circumference (p<0.001). Lower per capita income (p=0.035), reduced platelet count (p=0.003) were also significantly associated with NAFLD. No significant associations were observed with age, sex, occupation, physical activity, glycaemic control, lipid profile, liver enzyme levels.

Conclusion: NAFLD is highly prevalent among T2DM patients in this tertiary care setting in Uttarakhand. Obesity, central adiposity, and socioeconomic factors are key determinants. Routine screening using non-invasive tools and early lifestyle interventions are essential to prevent disease progression and related complications.

Keywords: NAFLD, Type 2 Diabetes Mellitus, FibroScan, CAP, Risk Factors.