Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2025; 17(2): 101936
Published online Feb 27, 2025. doi: 10.4254/wjh.v17.i2.101936
Association of non-alcoholic fatty liver disease with glycemic control among patients with type 2 diabetes mellitus at Limbe Regional Hospital, Southwest, Cameroon
Ebot Walter Ojong, Moses Njutain Ngemenya, Melvis Mwantem Tafili, Elvis Asangbeng Tanue, Eric Akum Achidi
Ebot Walter Ojong, Moses Njutain Ngemenya, Melvis Mwantem Tafili, Elvis Asangbeng Tanue, Eric Akum Achidi, Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Buea PO Box 63, Southwest, Cameroon
Eric Akum Achidi, Department of Biochemistry and Molecular Biology, University of Buea, Buea PO Box 63, Southwest, Cameroon
Author contributions: Ngemenya MN, Ojong EW, and Tafili MM conceived and designed the study; Tafili MM, Ojong EW, and Tanue EA participated in the data collection and data entry; Ojong EW, Achidi EA, and Tanue EA analyzed the data and performed the background literature review for the manuscript; Ojong EW, Ngemenya MN, and Tafili MM drafted the manuscript. All authors reviewed, edited, and approved the final version of the manuscript.
Institutional review board statement: The approval for this study was obtained from the Institutional Review Board, Faculty of Health Sciences, University of Buea, Cameroon (approval ID: 2024/2312-01/UB/SG/IRB/FHS). Authorization to collect research data was obtained from the Ministry of Public Health, Cameroon (40/MPH/SWR/RHL/DO/04/2024).
Informed consent statement: Written informed consent was obtained from all participants before recruitment into the study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: The data that support the findings of this study are available on request from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ebot Walter Ojong, MSc, PhD Chemical Pathology, Senior Lecturer, Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Buea PO Box 63, Southwest, Cameroon. ebot.ojong@ubuea.cm
Received: October 1, 2024
Revised: December 5, 2024
Accepted: January 2, 2025
Published online: February 27, 2025
Processing time: 141 Days and 13 Hours
Abstract
BACKGROUND

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease characterized by combinations of insulin resistance and insulin deficiency. Non-alcoholic fatty liver disease (NAFLD) is emerging as a public health problem worldwide and affects up to 70% of patients with T2DM. Although patients with T2DM have an increased risk of developing advanced liver disease compared to healthy individuals, varying prevalence rates of NAFLD among patients with T2DM, ranging from 34% to 94%, have been reported.

AIM

To determine prevalence and identify associated factors of NAFLD among Limbe patients with T2DM and evaluate correlation with glycemic control.

METHODS

A cross-sectional study was carried out from February to June 2024 among patients with T2DM. Gamma-glutamyl transferase (GGT) activity and serum triglycerides (TGs) were measured by spectrophotometry. NAFLD was diagnosed using the fatty liver index score. Data were analyzed using SPSS version 26.0 for Windows. Student’s t-test was used to compare the means of two groups. The χ2 test was applied to determine the association of NAFLD and T2DM. Logistic regression analysis was performed to identify predictors of NAFLD. P < 0.05 was considered statistically significant.

RESULTS

Of the 150 patients with T2DM recruited for this study, 63 (58%) were females and the majority (84.7%) had good glycemic control (glycated hemoglobin < 7%). Prevalence of NAFLD among patients with T2DM was 19%. Patients with NAFLD had significantly elevated levels of TGs, GGT, and increased body mass index and waist circumference compared to those without NAFLD. There was a significant association between NAFLD and glycemic control. Predictive factors of NAFLD among patients with T2DM were vegetable intake of less than three times per week [adjusted odds ratio (aOR): 0.131, 95%CI: 0.020-0.839; P = 0.032], central obesity (aOR: 0.167, 95%CI: 0.037-0.748; P = 0.019), and metformin treatment for T2DM (aOR: 0.167, 95%CI: 0.037-0.718; P < 0.001).

CONCLUSION

The prevalence of NAFLD in patients with T2DM in Limbe Regional Hospital was 19%. Age, central obesity, metformin use, and infrequent consumption of vegetables were important predictors of NAFLD.

Keywords: Type 2 diabetes mellitus; Non-alcoholic fatty liver disease; Glycemic control; Correlation; Factors

Core Tip: Few studies have evaluated the association between non-alcoholic fatty liver disease (NAFLD) and glycemic control in Africa. This study was the first to be conducted in Cameroon and the Central African Region. NAFLD was evaluated using the fatty liver index algorithm recommended for resource limited settings. One of five patients with type 2 diabetes mellitus in Limbe, Cameroon suffer from NAFLD, which is significantly associated with glycemic control. Findings from this study support clinical practice guidelines recommending screening individuals with diabetes for NAFLD and contribute to the scarce data on the topic in Africa. Future longitudinal studies are needed.