Ultrasound findings of hepatic steatosis as an indicator of abnormal glucose tolerance

Background: Almost all patients in departments of internal medicine routine ly undergo abdominal ultrasound examination in which liver changes indicati ng hepatic steatosis are often detected. The aim of this study was to asses s the occurrence of pathological oral glucose tolerance, manifest diabetes mellitus and other changes indicative of a metabolic syndrome in patients w ith sonographic signs of hepatic steatosis. Patients and methods: 577 patients were examined during a period of 6 month s: 90 patients fulfilled the inclusion criteria. Results: Among the 90 patients with echodense liver who were included in th e study (42 female, 48 male) 36 patients presented with previous diagnosis of diabetes mellitus (40%). The oral glucose tolerance test was impaired in 19 patients (21%) and in four patients with manifest diabetes mellitus (4% ). Among patients with echodense liver a high percentage presented with obe sity and impaired fat metabolism. Conclusions: The large number of patients with an impaired oral glucose tol erance test converting to manifest diabetes, as well as the large number of patients with manifest disorders of fat metabolism suggest that screening for diabetes should be performed in patients who present with sonographic s igns of hepatic steatosis.