Introduction: Nonalcoholic Fatty Liver Disease (NAFLD) is a spectrum of liver diseases characterized by the presence of ectopic fat in the liver and steatosis, which cannot be explained by alcohol consumption. The association between NAFLD and Type 2 Diabetes Mellitus (T2DM) is well established. As liver fibrosis progresses in a patient with NAFLD, Insulin Resistance (IR) increases and may worsen diabetes control. The APRI score is a simple, inexpensive bedside marker that can detect liver fibrosis and cirrhosis. Several studies have shown an association between APRI and NAFLD. However, there is a gap in correlation with IR in patients with diabetes. In this study, we sought to correlate IR and NAFLD in diabetes using the APRI score.
Methods: This observational cross-sectional hospital based study was conducted in the Department of General Medicine, one of the tertiary care hospitals in North India, from February 2019 to July 2020. A total of 70 patients were taken for the study. Patients with type 2 diabetes mellitus, aged>30 years, who had no history of alcohol use and who had or were newly diagnosed with NAFLD were enrolled in the study.
Results: From our study, there was a significant difference in mean Homeostatic Model Assessment-2 Insulin Resistance (HOMA2 IR) between NAFLD grade 1, grade 2 and grade 3. The inter-group comparison of mean HOMA2 IR was done using the post-hoc Bonferroni test. We applied Pearson correlation to the overall values of APRI and HOMA2 IR and found a significant positive correlation between the two.
Conclusion: In conclusion, we found that APRI can also be used to assess the degree of insulin resistance and may provide important information for improving glycemic control in T2DM with NAFLD.