The Effect of Comorbidities in NAFLD and Its Impact on Disease Progression

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) affects 25–30% of adults worldwide and is closely linked to metabolic syndrome. It ranges from simple steatosis to cirrhosis and hepatocellular carcinoma, with key comorbidities including obesity, type 2 diabetes mellitus (T2DM), dyslipidaemia, and hypertension. Cardiovascular disease is the leading cause of death in NAFLD. Methodology: A cross-sectional study was conducted at Narayana Medical College (Nov 2024–Apr 2025), involving 150 NAFLD patients aged >30 years with comorbidities. Data collection included clinical exams, questionnaires, and lab tests. Results: Most patients were aged 40–60 (59.33%) and female (62%). A majority consumed mixed diets (80%). Obesity was present in 30.67%, with 24% having obesity class II. Comorbidities included obesity (14.67%), T2DM (8%), dyslipidaemia (4.67%), and hypertension (4%). The most common combination obesity, T2DM, and dyslipidaemia (26.67%) was associated with advanced liver pathology (steatosis, fibrosis, cirrhosis). Severity increased with comorbidity burden, supporting the multiple-hit hypothesis. Conclusion: NAFLD was most common in middle-aged females. Combined metabolic comorbidities markedly worsened disease severity, underscoring the need for early detection and intervention.