Ultrasonographic Evaluation of Severity of Hepatic Steatosis in Type2 Diabetic Patients Treated with Oral Hypoglycemic Drug Metformin- Correlation with Serum C-Peptide and Triglyceride Level

This cross sectional study was carried out in the department of radiology and imaging, BIRDEM in collaboration with department of Cell and Molecular Biology, Research division, BIRDEM from June 2006 to May 2007 with an aim to investigate the role of transabdominal sonography to diagnose fatty change in liver in patients suffering from type2 diabetes mellitus treated with metformin and to correlate the grading of fatty change to c-peptide and triglyceride levels. The study was conducted in 92 type2 diabetic patients from both sexes between 44 years to 68 years of age. In present study, hepatic steatosis at ultrasonography was considered as grade-0 (normal liver echogenicity without any fatty infiltration); grade-1 (minimal diffuse increase in hepatic echogenicity, normal visualization of diaphragm and intrahepatic vessel borders); grade-2 (moderate diffuse increase in hepatic echogenicity, slightly impaired visualization of intrahepatic vessels and diaphragm) and grade-3 (marked increase in liver echogenicity; poor or nonvisualization of the hepatic vessels and diaphragm). In this study, out of 92 subjects, fatty infiltration in liver (increased hepatic echogenicity) of different grade was detected in 72 subjects by ultrasonography. Significant age differences were found between four groups. Fasting c-peptide and triglyceride showed significant difference between grade-0, grade-1, grade-2 and grade-3 liver echogenicity. Waist hip ratio (WHR) showed significant difference between grade-0, grade-1, grade-2 and grade-3 liver echogenicity. Body mass index (BMI) also showed significant difference between grade-0, grade-1, grade-2 and grade-3 liver echogenicity. Waist hip ratio (WHR), serum triglyceride (Tg), grade of liver echogenicity and body mass index (BMI) had significantly positively associated with fasting c-peptide (FCP) level. It was also observed that type 2 diabetes mellitus is a predisposing factor for the development of fatty liver. At the same time, it was seen that increased body mass index (BMI) plays an important role in its development. Waist hip ratio (WHR) has an association with the severity of fatty change in the liver. It was also observed that there is a linear correlation between the severity of liver echogenicity and fasting c-peptide and triglyceride level.

Keywords: Ultrasonographic, Hepatic Steatosis, Type2 Diabetic, Serum C-Peptide, Triglyceride Level.