Introduction: ICMR INDIAB study (2023), found the prevalence of diabetes in India as11.4%. NAFLD is highly prevalent in people with diabetes. NASH is characterised by hepatocyte ballooning, lobular inflammation bridging necrosis, denotes a progressive liver disease. Newsome et al., postulated Fibro scan-AST (FAST) scores to detect NASH, elevated NAFLD activity score (NAS more than 4) and significantly more than F2 on liver biopsy. The nonHDLc to HDLc ratio may show combined lipid problems and was found to be a better predictor for multiple dyslipidemia-related disorders, such as coronary heart disease (CHD), insulin resistance, metabolic syndrome and chronic kidney disease than relying on single lipoprotein or the apoB/apoA1 ratio.
Aim: To assess the prevalence of NASH in people with diabetes using FAST scores in a tertiary care centre in India and its correlation with nonHDL/HDL ratio.
Material and Methods: Fibroscan was used to measure liver stiffness measurements in 229 people with diabetes. Current Hba1c and lipid profile, AST, were recorded and used to calculate Non HDL/HDL ratio and FAST scores.
Results: index study had 48% males and 52% females, mean age was 50.2 years, duration of diabetes was 7.9years, mean Hba1c was 8.7%, median stiffness was 8.7kpa, BMI 27.5%, WC was97.12 cm.167 (72%) had a FAST score of equal to less than 0.35 predicting low probability of NASH,50 (21.8%) people had indeterminate FAST scores (0.35 -0.67), and 12 (6.2%) people with diabetes had a FAST score of more than or equal to 0.67, denoting high probability of NASH. FAST scores correlated positively with Non HDL/HDL ratio at a correlation coefficient of .137, which was statistically significant (p<0.05).
Conclusion: Non HDL /HDL ratio, an easy to perform test in routine clinical practice, can be used to evaluate for NASH and more severe stages of NAFLD in people with diabetes.
A. Tewari: None. A. Maheshwari: None. J. Tewari: None. V. Tewari: None.
