STUDY TO IDENTIFY VARIOUS STAGES OF HEPATIC CHANGES IN METABOLIC SYNDROME

Abstract

Background: A spectrum of liver damage ranging from simple steatosis to Non Alcoholic Fatty Liver Disease (NAFLD) , Nonalcoholic Steatohepatitis (NASH), advanced \uf001brosis, and rarely ,Hepatocellular Carcinoma has been associated with Metabolic Syndrome .Various study in past have tried to establish association between serological markers and these liver disorder , but have not been proven to be effective in determining the further prognosis of disease. Aims and Objective: To determine the prevalence of NAFLD & other grades of Liver disorder in MS and establish a correlation between various serological parameters grades of Liver disorder in USG and to calculate BMI in NAFLD patients to determine the presence of Lean NASH. Materials and methods: Detailed history, sociodemographic pro\uf001le and serum markers including Hb, Lipid pro\uf001le, ALT, AST, FBS, hsCRP, Fasting insulin level were estimated in 200 patients of Metabolic Syndrome (NCEP ATP III) at the Department of Medicine, NRS Medical College & Hospital, Kolkata from August 2019 to August 2020. Diagnosis of NAFLD was made using USG and patients were Grouped in to Grade 1 (mild steatosis), Grade 2 (moderate steatosis) and Grade 3 (severe steatosis). Waist circumference, Serologic Markers & BMI was evaluated amongst all group to identify the presence of NAFLD & NASH. Results: In our study cohort , Liver steatosis of any grade was 66% and signi\uf001cantly Higher in patients with age group >52 years. Steatosis was signi\uf001cantly higher in patients with smokers ,T2DM , FBG >110 mg/dL, increasing SGPT , Total Chol ≥200 mg/dL ,S Triglycerides ≥150 mg/dL ,WC ≥90 cm ,SBP of ≥130 mmHg , DBP ≥80 mmHg , LDL >130 mg/dL, HDL <30 mg/dL , fasting insulin >25 units , WHR between 0.9-1.1 .Some of those with WC <90 cm , TG >150 mg/dL , LDL >130 mg/dL , HDL level <40 ,Fast Insulin >25 units also had NASH which was Comparable to Overweight & Obese suggesting the importance of NASH even in Otherwise Lean patients. Conclusion: Any grade of Steatosis was higher amongst MS patients. Most of them had direct association with WC, TG, LDL, TC, ALT, serum uric acid, hSCRP and fasting insulin abdominal obesity, WHR, fasting blood sugar, and inverse correlation with HDL. We also found signi\uf001cant NAFLD amongst the patients of MS and Normal BMI .