Effectiveness of Indian Diabetes Risk Score as a Screening Tool for Non-alcoholic Fatty Liver Disease: A Study from Anand, Gujarat, India

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) is widely prevalent in the Gujarati population and also shares risk factors with other Non-communicable diseases (NCDs) such as diabetes, obesity, and metabolic syndrome. Hence, more established screening tools like Indian Diabetes Risk Score (IDRS) may be considered for screening of NAFLD. Aim: To evaluate the prevalence of NAFLD in Anand, Gujarat and to assess whether IDRS may be used as a screening tool for NAFLD in Gujarat. Materials and Methods: A cross-sectional observational study involving 217 participants with a mean age of 56.83±11.39 years was conducted at the Health Check-up department at Shree Krishna Hospital, Anand, Gujarat, India. Participants were classified as having NAFLD using the USG parameters. Their IDRS score was calculated and applied to the participants following which its ability to screen NAFLD was compared with that of screening tools such as BMI, W/H Ratio and HBA1c, and risk factors associated with NAFLD. The IDRS was classified as high (≥60), medium (30-50), and low (<30) risk. Using univariate analysis in STATA (14.2), factors associated with NAFLD were identified, following which stepwise logistic regression analysis was performed. Differences between the risk groups of IDRS were tested using the chi-square test and analysis of variance. Results: The prevalence of NAFLD (37.79%) was significantly higher among those with a high (67.7%) and medium IDRS (16%) compared to the low IDRS group (7.4%) (trend chi-square; p<0.001). In stepwise logistic regression, IDRS was associated with NAFLD with an adjusted odds ratio of 1.03 (95% confidence interval 1.00-1.07 with a p-value of 0.036), even after adjusting for potential confounders. Conclusion: IDRS score can be used to screen for the prevalence of NAFLD.

Keywords

• gujarati population
• metabolic syndrome
• obesity