Introduction: As per the recent International Diabetes Federation (IDF) atlas, there are 537million adults living with diabetes. Indians with the same body mass index (BMI) have higher central adiposity and insulin resistance compared to Caucasians. High insulin resistance in people with diabetes predisposes them to Nonalcoholic Fatty Liver Disease (NAFLD) . TG/HDL ratio is emerging as a sensitive marker of insulin resistance. Liver stiffness measurements predict advanced fibrosis in people with diabetes. The current study aims to correlate TG/HDL ratio and liver stiffness measurements using fibro scans in people with diabetes.

Material and Methods: A total of 181 people with diabetes coming for the first time at our center underwent liver stiffness measurements using fibro scans after taking consent, people on prior lipid-lowering therapy and thiazolidinedione therapy were excluded from the study.

Results: Median stiffness ranged from 2.3kpa to 34.8kpa (median of 8.0kpa) , TG/ HDL ratio values ranged from 0.5-29.3 (median of 4.5) . Median stiffness, correlated with TG/HDL ratio correlation coefficient, was 0.2 (p 0.01) . Further 26.5% subjects had advanced fibrosis (Liver stiffness measurement (LSM) >9.1) , 23.7% of male subjects and 30% of female subjects had advanced fibrosis. Males and females with LSM >9.1 had high TG/ HDL ratio, mean 4.9 in males (range 2.5-13.7) and 4.9 in females (range 1.0-17) . These values were much higher than TG/HDL values of 0.9 and 1.2 used in females and males respectively, as cutoffs to predict insulin resistance.

Discussion: Previous studies have correlated TG/HDL ratio with NAFLD in nondiabetic individuals using ultrasonography. Fibro scan is a more sensitive and specific modality to screen for NAFLD. Median stiffness predicts liver fibrosis. There is a high incidence of advanced fibrosis in the index study, which correlated with TG/HDL ratio. All male and female subjects with advanced fibrosis had a high TG/HDL ratio.


A.Tewari: None. R.Choudhury: None. V.Tewari: None. J.Tewari: None. B.Saboo: None. A.Shrivastava: None. S.S.Dariya: None. V.Chavda: None. D.Hasnani: None. A.V.Inamdar: None.

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