COMPARATIVE STUDY OF HEPATIC CHANGES IN PATIENTS OFMETABOLIC SYNDROME AND CHRONIC ALCOHOLISM

Aims and Objective: Comparative study of hepatic changes in patients of metabolic syndrome and chronic alcoholism.Material and Method: The material of the study included 30 metabolic syndrome patients and 30 chronic alcoholicsselected from the medicine outdoor clinic (including diabetic clinic) and medicine indoor wards as well as from GI clinic ofPostgraduate Department of Medicine, S.N. Medical College and Hospital Agra .Results: Most metabolic syndrome patients (60%) as well as chronic alcoholics (50%) were asymptomatic. Anorexia andfatigue/ malaise was present in 13.3% and 40% respectively in metabolic syndrome patients as compared to anorexia(30%) and fatigue / malaise (50%) in chronic alcoholics. Nausea / vomiting and right upper abdominal quadrant pain waspresent in 10% metabolic syndrome patients as compared Nausea / vomiting (40%) and Right upper abdominal quadrantpain(26.6%) in chronic alcoholics.Hepatomegaly and icterus was present in 23.3% and 10% respectively in metabolic syndrome patients as comparedhepatomegaly (80%) and icterus (60%) in chronic alcoholics. Ascites and upper GI bleeding was present in 13.3% and6.7% metabolic syndrome patients respectively as compared to ascites (50%) and upper GI bleeding (9%) in chronicalcoholics.Mean AST and ALT levels were 65.56 + 67.22 and 84.9 + 91.9 U/L respectively in metabolic syndrome patients. AST/ALT ranged from 0.91 to 1.85 with mean of 0.98 + 0.26 while in chronic alcoholics mean AST and ALT levels were 98.4and 48.2 .AST and ALT levels were statistically significant (p value<0.05) in chronic alcoholics and the AST/ ALT was2.04. Gamma glutamyl transferase enzyme level was elevated in most (80%) chronic alcoholics while was near normal inmetabolic syndrome patients.On ultrasonography most of chronic alcoholics (93.3%) had abnormal findings like fatty liver (80%), cirrhosis (13.3%) ascompared to metabolic syndrome patients having NAFLD (33.3%), and cirrhosis (6.67%).On Histological examination metabolic syndrome patients had NAFLD in 33.3%, NASH in 41.6% and cirrhosis in 8.3% ascompared to chronic alcoholic patients having fatty liver in 35.7%, alcoholic hepatitis in 49.9% and cirrhosis in 14.3%.Conclusions:a. Symptoms like anorexia, fatigue/malaise, nausea/vomiting, right upper abdominal pain and signs likehepatomegaly, icterus, Splenomegaly, ascites, UGI bleeding were compared and statistically significant (pvalue<0.05) Symptomatology and signs were found in chronic alcoholics as compared to metabolic syndromepatients.b. Statistically significant (p value <0.05) deranged liver function tests were found in chronic alcoholics as comparedto metabolic syndrome patients.www.advancejournals.orgOpen Access Scientific PublisherInternational Journal of Medicine & Health ResearchIJM 35|Volume 1|Issue 1|20152c. On Hepatic Ultrasonography statistically significant (p value <0.05%) hepatic changes in the form of fatty liver,cirrhosis were observed in 93.4% patients of chronic alcoholics as compared to metabolic syndrome patients(60%).d. Patients with hepatomegaly, abnormal liver function tests and abnormal ultrasonographic findings were observedas high risk cases. Histopathological assessment of high risk patients revealed significant changes in the form ofNAFLD (33.3%), NASH (41.6%) and cirrhosis (8.3%) in metabolic syndrome patients as compared to chronicalcoholics in the form of alcoholic fatty liver (35.7%), alcoholic hepatitis (49.9%) and cirrhosis (14.3%).e. Statistically positive correlation of high risk group patients has shown abnormal ultrasonographic finding, abnormalliver function tests and the histopathological changes in the patients of both the groups. Though statistically (pvalue <0.05) significant changes were seen in chronic alcoholics as compared to metabolic syndrome patients