Category: Diabetes/Prediabetes/Hypoglycemia

Monitor: 6

6 - Non alcoholic fatty liver disease and carotid artery intima medial thickness in type 2 diabetes mellitus as a predictor of atherosclerosis

Thursday, Apr 25
11:30 AM – 12:00 PM

Objective : Non alcoholic fatty liver disease (NAFLD) is a growing epidemic worldwide due to obesity and insulin resistance and is considered as hepatic component of metabolic syndrome (MS). Therefore these patients are at increased risk of atherosclerosis and cardiovascular mortality. Carotid intima medial thickness (CIMT) is useful non invasive tool for detection of subclinical atherosclerosis.


Methods :

A total of 100 cases with Type II Diabetes mellitus were selected. Fifty patients with NAFLD, confirmed on ultrasound as cases and 50 controls with normal liver parenchyma underwent carotid artery Doppler for measurement of CIMT. Informed consent taken and ethics committee approved the study.
Inclusion criteria: Non-alcoholic patients above age of 18 years with type 2 diabetes mellitus
Exclusion criteria: Patients with hepatitis, chronic liver disease, on hepatotoxic drugs, acute/chronic kidney disease, pregnancy, malignancy, smokers & alcoholics.
Age, gender, body mass index were recorded. Fasting & postprandial plasma glucose, lipid profile, glycosylated hemoglobin, SGOT &SGPT were done.
B-mode ultrasonography done to detect fatty changes in the liver. CIMT was measured in both common carotid arteries one centimeter below bifurcation.
Data was analyzed on SPSS 20.0 and results were compared for the two groups


Results : We assessed 50 patients with NAFLD (32 males, 18 females) and 50 controls (25 males, 25 females). Mean patient age in NAFLD group was 59.34 years & 58.14 years in control group. Mean body mass index (BMI) of NAFLD group was slightly lower as compared to the controls. In NAFLD group 27 had Grade 1 NAFLD and 23 cases had Grade 2. Mean CMIT in NAFLD group was 0.84±0.10 mm and in control group 0.78±0.15 mm (p=0.025) Both SGOT and SGPT levels were found to be higher in cases compared to controls with p value <0.01. FBS and PPBS levels were higher in cases


Discussion : In our study, incidence of NAFLD was found higher in males and increased CIMT was found in cases compared to controls although not statistically significant. However both SGOT and SGPT were elevated in cases compared to control which was significant statistically (p<0.01)


Conclusion : In our study, incidence of NAFLD was found higher in males and increased CIMT was found in cases compared to controls although not statistically significant. However both SGOT and SGPT were elevated in cases compared to control which was significant statistically (p<0.01), indicating the routine use of these enzymes for early detection of NAFLD. NAFLD and CIMT can be detected by ultrasonography which is simple non-invasive test that will help in early diagnosis and treatment of cardiovascular complications

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Sreenivasamurthy L

Professor
Dr B R Ambedkar Medical college
Bengaluru, Karnataka, India

 A compètent ‘Medical Practitioner (Diabetology)’ with over 16 years of experience in ‘Medical Consultation & Health Care Advisory Services, Research Studies and Hospital Administration’.
 Possesses vast experience in managing complete ‘Medical/ Clinical Consultancy as well as handling intensively sick patients and performing procedures on high risk patients’.
 Demonstrated acumen in leading and managing the medical surgeries as well as effectively discharging the related functions and achieving higher rate of organic growth.
 ‘Vast t Part of Landmark Trials like ‘HOPE-3, Clarify, BEGIN-BOOST, Degludec, ELIXA, and EFC’ etc.
 Member of ‘Past Executive Committee Member’ – ‘Association of Physicians of India, Karnataka
Chapter in 2006’.
 Part of ‘Organizing Committee’ – ‘National conference of Physicians - APICON 2018’.
 Strong communication skills, analytical ability and ability to perform all the mentioned services under stress and strenuous conditions.
 Medical / Clinical Consultancy.
 Medical Advisory Services.
 Research Studies/Teaching.
eaching experience’ in both undergraduate and postgraduate as well as conducted more than ‘60 multinational clinical trials and delivered national/ international conferences’.
 Faced Successful ‘US FDA AUDIT (2012)’ in the field of Research.
 Faced ‘CANADAIAN AUDIT (Jan 2018)’ successfully, outside Canada for the first time in the world.

Roshini Revankar

Postgraduate
Dr B R Ambedkar medical college

Post graduate

Sreenivasamurthy L

Professor
Dr B R Ambedkar Medical college
Bengaluru, Karnataka, India

 A compètent ‘Medical Practitioner (Diabetology)’ with over 16 years of experience in ‘Medical Consultation & Health Care Advisory Services, Research Studies and Hospital Administration’.
 Possesses vast experience in managing complete ‘Medical/ Clinical Consultancy as well as handling intensively sick patients and performing procedures on high risk patients’.
 Demonstrated acumen in leading and managing the medical surgeries as well as effectively discharging the related functions and achieving higher rate of organic growth.
 ‘Vast t Part of Landmark Trials like ‘HOPE-3, Clarify, BEGIN-BOOST, Degludec, ELIXA, and EFC’ etc.
 Member of ‘Past Executive Committee Member’ – ‘Association of Physicians of India, Karnataka
Chapter in 2006’.
 Part of ‘Organizing Committee’ – ‘National conference of Physicians - APICON 2018’.
 Strong communication skills, analytical ability and ability to perform all the mentioned services under stress and strenuous conditions.
 Medical / Clinical Consultancy.
 Medical Advisory Services.
 Research Studies/Teaching.
eaching experience’ in both undergraduate and postgraduate as well as conducted more than ‘60 multinational clinical trials and delivered national/ international conferences’.
 Faced Successful ‘US FDA AUDIT (2012)’ in the field of Research.
 Faced ‘CANADAIAN AUDIT (Jan 2018)’ successfully, outside Canada for the first time in the world.

Sreenivasamurthy L

Professor
Dr B R Ambedkar Medical college
Bengaluru, Karnataka, India

 A compètent ‘Medical Practitioner (Diabetology)’ with over 16 years of experience in ‘Medical Consultation & Health Care Advisory Services, Research Studies and Hospital Administration’.
 Possesses vast experience in managing complete ‘Medical/ Clinical Consultancy as well as handling intensively sick patients and performing procedures on high risk patients’.
 Demonstrated acumen in leading and managing the medical surgeries as well as effectively discharging the related functions and achieving higher rate of organic growth.
 ‘Vast t Part of Landmark Trials like ‘HOPE-3, Clarify, BEGIN-BOOST, Degludec, ELIXA, and EFC’ etc.
 Member of ‘Past Executive Committee Member’ – ‘Association of Physicians of India, Karnataka
Chapter in 2006’.
 Part of ‘Organizing Committee’ – ‘National conference of Physicians - APICON 2018’.
 Strong communication skills, analytical ability and ability to perform all the mentioned services under stress and strenuous conditions.
 Medical / Clinical Consultancy.
 Medical Advisory Services.
 Research Studies/Teaching.
eaching experience’ in both undergraduate and postgraduate as well as conducted more than ‘60 multinational clinical trials and delivered national/ international conferences’.
 Faced Successful ‘US FDA AUDIT (2012)’ in the field of Research.
 Faced ‘CANADAIAN AUDIT (Jan 2018)’ successfully, outside Canada for the first time in the world.

Shashank Joshi

Senior Endocrinologist
Lilavati and Bhatia Hospital
Mumbai, Maharashtra, India

Prof Shashank R. Joshi MD, DM, FACP, FACE, FRCP
Endocrinologist, Lilavati & Bhatia Hospital
Consultant and Advisor, Apollo Sugar Clinics
President, Indian Academy of Diabetes, Past President, Endocrine Society of India
Past President, Research Society for Study of Diabetes in India(RSSDI)
Past President, All India Association for Advancement of Research in Obesity Past President, Association of Physicians of India, Emeritus Editor, JAPI
Indian Chapter Chair, AACE
He was honored by the Government of India, in 2014, by bestowing on him the Padma Shri, the fourth highest civilian award, for his services to the field of medicine. He is also a recipient of the International Clinician Award, received at the 21st American Association of Clinical Endocrinologists (AACE) Annual Scientific and Clinical Congress, Philadelphia. This is an annual award given to practicing endocrinologists, outside the US