Correlation of Glycaemic Control and BMI with Renal Profile in Type 2 Diabetic Patients with and without Non Alcoholic Fatty Liver Disease: A Case-control Study

Abstract

Introduction: Obesity is a risk factor for the development of diabetes, and these two are directly implicated in an individual’s risk of developing Non Alcoholic Fatty Liver Disease (NAFLD), which is a major factor in Metabolic Syndrome (MS). NAFLD and Type 2 Diabetes Mellitus (T2DM) are known to frequently coexist and act synergistically to elevate the risk of hepatic as well as extrahepatic complications. Aim: To determine the levels of renal profile, electrolytes, Glycosylated Haemoglobin (HbA1c), and Body Mass Index (BMI) in T2DM patients with and without NAFLD, as well as in control subjects, and to assess the correlation of BMI and HbA1c with renal profile and electrolytes in T2DM patients with and without NAFLD. Materials and Methods: This case-control study was conducted in the Department of Biochemistry and the Diabetes Speciality Clinic in the Department of General Medicine at MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India, from December 2021 to March 2023. The study included a total of 90 subjects divided into three groups (30 in each): Group 1-Control, Group 2-T2DM with NAFLD, and Group 3-T2DM without NAFLD. Aseptic blood collection was performed, and Renal Function Test (RFT), electrolytes, and HbA1c levels were analysed. Group comparisons were done using unpaired t-tests, and correlation analysis was conducted using Pearson’s correlation with Statiistical Package for Social Sciences (SPSS) software version 25.0. Results: The authors found that 57% of the total enrolled population were female, while the remaining 43% were male, with a mean age of (49.03±5.09) years. Mean levels of HbA1c (9.55±1.78, 8.61±1.42%), BMI (28.84±4.19, 23.51±2.09) kg/m², Urea (31.62±6.28, 33.02±5.11) mg/dL, Creatinine (1.29±0.18, 1.36±0.10) mg/dL, and Uric acid (6.74±1.19, 6.01±0.83) mg/dL were found to be significantly higher in Group 2 and Group 3, respectively, compared to controls. A positive significant correlation of BMI with uric acid, HbA1c with urea, creatinine, and uric acid in Group 2 and 3 was observed. However, no derangement was observed concerning electrolytes in any group. Conclusion: The correlation of urea, creatinine, and uric acid with HbA1c provides the authors with information on impaired renal function in diabetic as well as NAFLD participants. Hyperuricaemia in these individuals can aggravate the risk of T2DM and NAFLD, leading to its progression in Non Alcoholic Steatohepatitis (NASH), respectively.