article · Dr Sulaiman Al Habib Medical Journal
Nonalcoholic fatty liver disease presents a notable health burden among individuals with type 2 diabetes, yet data from sub-Saharan Africa remain limited. A cross-sectional hospital study of 318 adult diabetes outpatients in Tanzania examined the occurrence and characteristics of the condition using abdominal ultrasound alongside clinical measurements. Nonalcoholic fatty liver disease was detected in 18.9 percent of the patients, with diffuse fatty infiltration appearing as the primary pattern. Most identified cases were mild, while a smaller portion was moderate. Statistical analysis established that central obesity, measured via waist circumference, elevated total cholesterol, and poor blood sugar control were independent predictors of the condition. These findings highlight the presence of underdiagnosed liver steatosis in this patient group and demonstrate the utility of clinical markers and ultrasound for detection in regional healthcare settings.
Fatty liver disease often develops silently in people with diabetes and can lead to serious metabolic and cardiovascular complications. Understanding its prevalence and identifying clear physical and laboratory predictors helps clinicians recognise high-risk patients earlier. This enables targeted screening and timely interventions in resource-constrained healthcare environments.
The findings inform diagnostic screening protocols and risk-stratification pathways for healthcare providers and clinical diagnostic services in low-resource settings. By linking specific biomarkers like waist circumference and cholesterol to ultrasound results, the research provides clinical evidence for standardising diagnostic practices. This represents early-stage applied clinical research rather than a standalone commercial product.
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Abstract Background: Nonalcoholic fatty liver disease (NAFLD) is a common comorbidity among individuals with type 2 diabetes mellitus (T2DM) and contributes significantly to adverse hepatic and cardiometabolic outcomes. Early identification through imaging, particularly ultrasonography, plays a critical role in disease detection and risk stratification. However, the prevalence and sonographic profiles of NAFLD in sub-Saharan African populations with diabetes remain underexplored. Methods: This hospital-based cross-sectional study included 318 adult patients with T2DM attending the outpatient clinic at Muhimbili National Hospital–Mloganzila between March and August 2024. Sociodemographic, clinical, and laboratory data were collected. Abdominal ultrasound was used to assess hepatic echogenicity and classify the severity of steatosis. Bivariate associations were evaluated using Chi-square and Mann–Whitney U tests, and multivariable logistic regression was employed to identify independent predictors of NAFLD. Results: NAFLD was detected in 18.9% of patients, with diffuse fatty infiltration as the predominant sonographic pattern (96.7%). Most cases were graded as mild (76.7%) or moderate (20.0%). Female sex, increased body mass index, waist circumference, elevated cholesterol, and glycated hemoglobin (HbA1c) were associated with NAFLD in the univariate analysis. Multivariable regression identified waist circumference (adjusted odds ratio [aOR] 8.78, P < 0.001), high total cholesterol (aOR 1.47, P < 0.001), and elevated HbA1c (aOR 3.2, P = 0.011) as significant independent predictors. Conclusion: NAFLD is a prevalent yet likely underdiagnosed condition among patients with T2DM in Tanzania. Central obesity, dyslipidemia, and poor glycemic control are key predictors. These findings support integrating routine ultrasound screening and metabolic optimization into diabetes management pathways in similar low-resource settings.
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DOI: 10.4103/dshmj.dshmj_35_25
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