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Title: A prospective cross sectional study to determine the prevalence of nonalcoholic Steatohepatitis in adults with type 2 diabetes In an urban region of northwest India
Researcher: Panicker,Shashi
Guide(s): Ganesh Narain Saxena
Keywords: Clinical Medicine
Clinical Pre Clinical and Health
Medicine General and Internal
University: Mahatma Gandhi Univeristy of Medical Sciences and Technnology , Jaipur
Completed Date: 2020
Abstract: Background: Type 2 diabetes (T2D) and nonalcoholic steatohepatitis (NASH) are newlinestrongly correlated and independently increase the risk of cardiovascular disease newline(CVD). The current prevalence of NASH and significant risk factors in Indian newlinepatients with T2D is not known because of limitations in the methods of diagnosis of newlineNASH. Primary Aim: Determine the prevalence of NASH in a cohort of adults newlinewith type 2 diabetes. Secondary Aims: Identify significant risk factors and gender newlinedifferences, and evaluate the correlation of NASH with arterial stiffness (AS) in newlineT2D subjects. Materials and Methods: Approval from the Institutional Ethics newlineCommittee and informed consent of the participating patients were obtained. NASH newlinewas diagnosed by Transient Elastography with FibroScan when liver stiffness newlinemeasurement (LSM) was and#8805;7 kPa and NAFLD Fibrosis Score (NFS) was gt0.675. AS newlinewas measure by Aortic Pulse Wave Velocity (aPWV) with the PW Analyzer. newlineResults: NASH with significant fibrosis was present in 30% of the cohort of 613 newlineadults with T2D (35% women, 26% men). NASH existed in 78.1% women and newline61.4% men with SGPT below 40 IU/L. Multivariate analysis showed that Age, newlineWaist Circumference (WC), SBP, HbA1c, SGOT, SGGT, serum Albumin, total newlineCholesterol, Platelet count, NAFLD Fibrosis score and AS were independent newlinepredictors of NASH. The significant predictors of AS were age, hypertension, liver newlinestiffness, low platelet count and low serum albumin. The waist-to-height ratio was newlinethe most sensitive parameter of obesity. Gender differences were observed for both newlineNASH and AS. A negative correlation of serum albumin and platelet counts was newlineseen for both NASH and arterial stiffness. The association of LSM and AS was newlinemutually detrimental. The NAFLD Fibrosis score significantly correlated with LSM. newlineConclusions: The absence of elevated SGPT above 40 IU/L should not deter newlinephysicians from considering a diagnosis of NASH in patients with T2D. Liver newlinefibrosis and arterial stiffness were significantly associated with each other in a newlinemutually detrimental man
Appears in Departments:Department of General Medicine

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03_supervisor certificate.pdf178.32 kBAdobe PDFView/Open
05_declaration.pdf258.03 kBAdobe PDFView/Open
06_acknowledgement.pdf177.21 kBAdobe PDFView/Open
07_table of content.pdf178.8 kBAdobe PDFView/Open
08_list of tables.pdf291.11 kBAdobe PDFView/Open
09_list of figures.pdf292.35 kBAdobe PDFView/Open
10_list of abbreviations.pdf287.69 kBAdobe PDFView/Open
11_chapter 1.pdf1.08 MBAdobe PDFView/Open
12_chapter 2.pdf744.98 kBAdobe PDFView/Open
13_chapter 3.pdf1.37 MBAdobe PDFView/Open
14_chapter 4.pdf2.73 MBAdobe PDFView/Open
15_conclusions.pdf553.67 kBAdobe PDFView/Open
16_sumamry.pdf544.14 kBAdobe PDFView/Open
17_appendices.pdf2.13 MBAdobe PDFView/Open
18_bibliography.pdf750.78 kBAdobe PDFView/Open
80_recommendation.pdf44.85 kBAdobe PDFView/Open
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