الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus represents one of the most important health problems worldwide. The global prevalence of T2DM has reached epidemic proportions over the past few years due to global rise in the prevalence of obesity and unhealthy lifestyle. Increased morbidity and mortality in patients with type 2 diabetes (T2DM) is associated with large prevalence of atherosclerosis and cardiovascular diseases, chronic kidney disease and cancer, but also to a wide spectrum of chronic hepatic diseases ultimately able to lead to hepatic cirrhosis and hepatocellular carcinoma (HCC). Nonalcoholic fatty liver disease (NAFLD) is a prominent cause of chronic liver disease and recently, the prevalence of NAFLD has increased dramatically worldwide, making it a major cause of liver-related morbidity and mortality. Beyond its involvement in liver diseases, NAFLD has also been highlighted as a hepatic complication of type 2 DM. The perception of nonalcoholic fatty liver disease as an uncommon and benign condition is rapidly changing as approximately 70% of persons with type 2 diabetes mellitus have a fatty liver and the disease follows a more aggressive course with necro-inflammation and fibrosis (i.e. nonalcoholic steatohepatitis…NASH). NASH is a leading cause of end-stage liver disease and contributes to cardiovascular disease in patients with type 2 diabetes mellitus. Early detection of NAFLD in patients with type 2 DM helps in early management and prevents its progression into steatohepatitis and liver cirrhosis. Our cross sectional study aimed to assess prevalence of hepatic steatosis and fibrosis in T2DM patients and possible associated risk factors. We included 200 T2DM patients from our endocrinology & diabetes clinic and wards. The study protocol was approved by the institutional ethics committee and informed consents were obtained from the patients. All patients in this study were subjected to: history taking, full clinical examination, laboratory investigations including the following: Hemoglobin A1C, fasting and 2 hour postprandial blood glucose level, liver function tests (ALT, AST), lipid profile (total cholesterol, triglycerides, LDL, HDL), urinary albumin creatinine ratio, transient elastography examination. The following results were obtained: • High prevalence of hepatic fibrosis in our participants which was detected in 53.5% of participants and also hepatic steatosis which was detected in 98.5% of participants. • Incidence of hepatic steatosis and fibrosis was significantly associated with longer duration of DM, higher BMI, bad control of DM which assessed by HbA1C, higher lipid profile of patients, presence of metabolic syndrome, micro and macro-albuminuria detected by ACR. • No significant correlation between hepatic steatosis, fibrosis and liver enzymes elevation as it usually become elevated later on with advanced cases, so we cannot depend on it as screening tool for NAFLD and it is better to depend on TE.