Cytokeratin-18 Fragment Level As a Biomarker of Non-Alcoholic Fatty Liver Disease In Egyptian Patients With Type II Diabetes Mellitus

Abstract

aralleling the epidemic of obesity in both developed and developing countries, NAFLD has become the leading cause of liver disease, accounting for 20-40 % of the general population. It is apparently more slowly progressive than other chronic liver diseases, such as alcohol or viral-induced disease. However, because NAFLD is so common, occurring in 1 out of 3 persons in the developed world, it is the 3rd cause of liver transplantation in USA. Moreover, the problem of hepatocytes being fatty, overcomes the liver itself, as it increases the risk for cardiovascular disease & death & duplicates the risk for T2 DM, independently of the severity of liver injury. NAFLD represent a wide spectrum of hepatic injuries, which progress from simple fatty liver (NAFL) to steatohepatitis (NASH), liver cirrhosis or even HCC. Patients with T2DM have a higher risk of development of non-alcoholic fatty liver disease (NAFLD) than those without T2DM. The prevalence of NAFLD is increasing mostly likely due to the rise in obesity and diabetes. It is reported that 13.3% of deaths among diabetic patients are attributable to liver diseases, representing the increasing prevalence of NAFLD in patients with T2DM. In addition, the coexistence of T2DM and NAFLD is associated with increased cardiovascular mortality and morbidity. Therefore, providing early diagnosis and follow up of NAFLD in patients with T2DM is important.