Author(s): Guneet Kaur1, Satiya Bhushan Nayyar2, Tejinder Sikri3
A high prevalence of non-alcoholic fatty liver disease (NAFLD) has been reported
specially among patients with diabetes mellitus, however the prevalence of nonalcoholic
fatty liver disease among non-diabetic individuals is also considerable.
Some reports have proposed that NAFLD is more closely associated with insulin
resistance rather than metabolic syndrome itself and fasting hyperinsulinemia is
common in individuals with impaired glucose homeostasis and is widely accepted
surrogate measure of insulin resistance. In this study, we wanted to find out the
incidence of insulin resistance and dyslipidaemia in non-alcoholic fatty liver
This was a cross sectional study undertaken in Sri Guru Ram Das Institute of
Medical Sciences and Research, a tertiary care hospital, conducted on 100
consecutive non diabetic patients with diagnosis of NAFLD on ultrasonography
(USG) of whole abdomen. In all the patients, fasting plasma glucose, HbA1c,
fasting plasma insulin levels and fasting lipid profile were measured. Insulin
resistance (IR) using homeostatic model assessment (HOMA IR) formula was
calculated and analysed.
29.2 % patients of grade 1, 36.6 % of grade 2 and 81.8 % of grade 3 fatty liver
had raised serum cholesterol levels (P = 0.005). 31.3 % of grade 1, 56.1 % of
grade 2 and 72.7 % of grade 3 fatty liver had raised serum triglyceride levels (P
= 0.011). 33.3 % patients of grade 1, 48.8 % of grade 2 and 72.7 % of grade 3
fatty liver had raised serum LDL cholesterol levels (P = 0.043). 50.0 % of grade
1, 70.7 % of grade 2 and 81.8 % of grade 3 fatty liver low serum high density
lipoproteins (HDL) cholesterol levels (P = 0.047). Insulin resistance was present
in 39 % patients of NAFLD. 6.3 % patients of grade 1, 63.4 % of grade 2 and 90.9
% of grade 3 fatty liver had insulin resistance (HOMA-IR ≥ 1.8).
It was concluded that dyslipidaemia and insulin resistance had a significant
relationship with NAFLD.