ASSOCIATION BETWEEN METABOLIC SYNDROME WITH NON-ALCOHOLIC FATTY LIVER DISEASE OF DEVELOPMENT PATIENTS: A STUDY IN RAJSHAHI MEDICAL COLLEGE HOSPITAL, RAJSHAHI, BANGLADESH”

N. S. M. Momtazul Islam*, Md. Khalilur Rahman, Mohammad Mahbubur Rahman Khan, Mohammad Hasan Tarik, Mohd. Harun-or-Rashid, Mainuddin Ahmed, Colonel (Rtd) Md. Monirul Islam, Sadia Thamin

ABSTRACT

Introduction: Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of liver-related mortality worldwide. NAFLD encompasses a morphological spectrum from simple fatty liver (SFL), non-alcoholic steatohepatitis (NASH) to hepatic cirrhosis. SFL generally has a benign prognosis. Objective: The aim of this study was to examine the association between Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease of development Patients. Methods: A total of 3,509 individuals aged ≥50 years receiving an annual physical check-up in the Rajshahi Medical College Hospital, Rajshahi, Bangladesh were recruited to the study from January 2017 to December 2018. The majority of the participants were employees of various companies or organizations in RMCH. All participants were permanent residents of RMCH and were expected to have repeated examinations annually or biennially, which made the follow-up easier. Results: A total of 1,343 males and 574 females aged ≥50 years without NAFLD at baseline were included. Information on lifestyle, including alcohol use and personal history, was collected by face-to‑face interviews. Biochemical parameters were assayed using fasting blood samples. NAFLD was diagnosed by abdominal ultrasonography. During follow-up at an average of 4.8 years, 223 patients developed NAFLD. Following adjustment for multiple covariates, age was an independent protective predictor [hazard ratio (HR), 0.96; 95% confidence interval (CI), 0.95- 0.98], while the independent risk predictors were obesity (HR, 2.81; 95% CI, 2.14‑3.69), higher triglycerides (HR, 2.56; 95% CI, 1.95-3.32) and alanine aminotransferase (HR, 1.004; 95% CI, 1.000‑1.008). Participants with a diagnosis of MS had a significantly increased risk of developing NAFLD (HR, 3.17; 95% CI, and 2.42-4.14). A greater number of MS components was significantly associated with a higher risk of NAFLD (all adjusted P for trend <0.001). Compared with those without any components of MS, participants with only one component of MS had a 3.6-fold higher risk of developing NAFLD (adjusted HR, 3.64; 95% CI, and 1.50-8.88). The diagnosis and the number of components of MS were prospectively associated with the risk of developing NAFLD. Even in those with only one component of MS, the risk increased by 2.6-fold compared with that for the individuals without any components, suggesting a beneficial effect of intervention at the very early stage of MS on the prevention of NAFLD. Conclusion: In conclusion, we identified that the number of MS compo-nents was more useful than the presence of MS in predicting NAFLD. Individuals with only one component of MS had a 3.6-fold higher risk of developing NAFLD, suggesting a significantly higher risk of NAFLD in the extremely early stage of MS.

Keywords: Non-Alcoholic Fatty Liver Disease, Metabolic Syndrome, Elderly Individuals.