Study of Non-alcoholic Fatty Liver Disease (NAFLD) by Shear-wave Elastoraphy in Subjects with Metabolic Syndrome

Background: Non-alcoholic fatty liver disease (NAFLD) is well known to have a strong association with metabolic syndrome. The degree of liver fibrosis is related to the clinical course and prognosis. Shear-wave elastography (SWE) provides a precise non-invasive staging of the degree of liver fibrosis in NAFLD.  Aims and objectives: To study Non-alcoholic fatty liver disease (NAFLD) by Shear-Wave Elastography (SWE) in subjects with metabolic syndrome (MetS). Material and methods: This was a single centre, retrospective, comparative study done on patients with MetS in 100 in a tertiary care hospital over period of 18 months from October 2019 to March 2021. Enrolled patients underwent conventional ultrasonography (USG), point SWE (pSWE), fasting blood sugar, post-prandial blood sugar, glycosylated HbA1c, lipid profile, LFTs. Appropriate statistical tests were applied using SPSS v21 for analysis and p-value<0.05 was considered statistically significant. Results: Mean age was 55.8 (SD±15.34). Majority belonged to age group 51-65 years (33%). Grade 3 fatty liver (steatosis) on USG had 3.39 times independently (OR:3.39,p=0.043) more chance of having significant fibrosis or cirrhosis(F3-F4) by SWE over those who do not have fatty liver (steatosis) on USG. Those with 4 components of MetS had 6 times (OR:6.04,p=0.003) and those with 5 components had 13.7 (OR:13.768,p=0.001) times more chance of having significant fibrosis or cirrhosis(F3-F4) by SWE over those who have 3 components independently. Conclusion: Increasing number of components of MetS and steatosis (fatty liver grade) on USG were independently associated with higher grades of fibrosis by SWE.