Diabetes, metabolic syndrome and obesity : targets and therapy · 2025
High Prevalence of Fatty Liver in Bangladeshi Adolescents and Young Adults with Type 2 Diabetes: Key Predictors and Screening Recommendations.
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Shil Kishore Kumar, Hasan Mashfiqul, Sultana Nusrat, Salam Sayad Bin Abdus, Mostafa Syeda Nazlee, Hasanat Muhammad Abul
Аннотация
BACKGROUND: Obesity and insulin resistance are the key pathogenic factors for both metabolic dysfunction-associated steatotic liver disease (MASLD) and type-2 diabetes (T2DM), and their rising prevalence is driving an increase in MASLD cases.
OBJECTIVE: To assess the presence of fatty liver disease by ultrasonography (USG) and to find out its predictors in newly diagnosed young-onset T2DM.
METHODS: This cross-sectional study enrolled 137 newly diagnosed adolescents and young adult T2DM subjects (aged 10-34 years) by non-probability purposive sampling at a tertiary hospital in Bangladesh. Individuals with a history of alcoholism, pregnancy, infections, endocrinopathies, genetic disorders, or drugs that can cause fatty liver were excluded. Fatty liver was assessed by ultrasonography. C-peptide, anti-GAD65, and anti-IA2 antibodies were measured by chemiluminescent immunoassay, and anti-ZnT8 antibodies by ELISA.
RESULTS: Among 137 newly diagnosed adolescents and young adult T2DM patients, 92 (68.1%) had fatty liver on ultrasonography-58 (63%) with grade 1 and 34 (37%) with grade 2. Most were overweight/obese (67.2%), had central obesity (88.3%), and reported low physical activity (68.6%). Fatty liver was significantly associated with older age, higher BMI, WHR, and a positive family history of diabetes. On multivariate analysis, age (OR 1.14, 95% CI 1.04-1.25, p=0.004), positive family history of DM (OR 3.21, 95% CI 1.29-8.22, p=0.012), acanthosis nigricans (OR: 5.05, 95% CI 1.59-16.04, p=0.006), and fasting C-peptide levels (OR 1.46, 95% CI 1.10-1.92; p = 0.007) were significant predictors of fatty liver.
CONCLUSION: Fatty liver is highly prevalent in young-onset T2DM at diagnosis. Age, a positive family history of diabetes, acanthosis nigricans, and elevated fasting C-peptide levels are strong predictors. Routine use of ultrasonography may facilitate early detection and management of liver disease in this population.
OBJECTIVE: To assess the presence of fatty liver disease by ultrasonography (USG) and to find out its predictors in newly diagnosed young-onset T2DM.
METHODS: This cross-sectional study enrolled 137 newly diagnosed adolescents and young adult T2DM subjects (aged 10-34 years) by non-probability purposive sampling at a tertiary hospital in Bangladesh. Individuals with a history of alcoholism, pregnancy, infections, endocrinopathies, genetic disorders, or drugs that can cause fatty liver were excluded. Fatty liver was assessed by ultrasonography. C-peptide, anti-GAD65, and anti-IA2 antibodies were measured by chemiluminescent immunoassay, and anti-ZnT8 antibodies by ELISA.
RESULTS: Among 137 newly diagnosed adolescents and young adult T2DM patients, 92 (68.1%) had fatty liver on ultrasonography-58 (63%) with grade 1 and 34 (37%) with grade 2. Most were overweight/obese (67.2%), had central obesity (88.3%), and reported low physical activity (68.6%). Fatty liver was significantly associated with older age, higher BMI, WHR, and a positive family history of diabetes. On multivariate analysis, age (OR 1.14, 95% CI 1.04-1.25, p=0.004), positive family history of DM (OR 3.21, 95% CI 1.29-8.22, p=0.012), acanthosis nigricans (OR: 5.05, 95% CI 1.59-16.04, p=0.006), and fasting C-peptide levels (OR 1.46, 95% CI 1.10-1.92; p = 0.007) were significant predictors of fatty liver.
CONCLUSION: Fatty liver is highly prevalent in young-onset T2DM at diagnosis. Age, a positive family history of diabetes, acanthosis nigricans, and elevated fasting C-peptide levels are strong predictors. Routine use of ultrasonography may facilitate early detection and management of liver disease in this population.