Evaluation of Liver Fibrosis and Metabolic Risk in Non-Alcoholic Fatty Liver Disease

Background: Non-alcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver disorders worldwide. In India, its burden is rising fast due to increasing metabolic problems like diabetes, obesity, and dyslipidemia. The disease varies from simple fat accumulation to steatohepatitis and cirrhosis. This study aimed to assess the clinical, biochemical and imaging profile of NAFLD patients in a tertiary hospital at Dehradun, Uttarakhand. Methods: A hospital-based cross-sectional study was done for 12 months in the Department of General Medicine, Himalayan Institute of Medical Sciences. Ninety-one adults (≥18 years) diagnosed with NAFLD on ultrasonography were included. Patients with alcohol intake, viral hepatitis, or hepatotoxic drug use were excluded. Demographic data, laboratory values, and imaging findings were recorded. Fibrosis was assessed using liver elastography and NAFLD Fibrosis Score (NFS). Results: Out of 91 patients, 56 (61.5%) were males, mean age 53.1 ± 11.6 years. All had type 2 diabetes and 73 (80.3%) were diabetic for ≥6 years. Dyslipidemia seen in 57.1% and albuminuria in 60.4%. On ultrasonography, 69 patients (75.8%) had Grade II/III steatosis. Elastography showed significant fibrosis (≥F3) in 31 (34.1%) and NFS showed advanced fibrosis in 16 (17.6%). Mean HbA1c was 9.2% showing poor glycemic control. Conclusion: NAFLD patients in north India had high metabolic burden with poor diabetes control, dyslipidemia, and early kidney changes. About one-third already showed significant fibrosis. Early screening and integrated management focusing on metabolic control are essential to prevent disease progression.