Metabolic syndrome components as determinants of NAFLD progression in Bangladesh: a cross-sectional study

Abstract Background Non-alcoholic fatty liver disease (NAFLD) has become an increasingly common liver disorder in Bangladesh, largely driven by changes in lifestyle and the rising burden of metabolic syndrome (MetS). This study aimed to investigate the clinical, metabolic, and biochemical features of NAFLD among Bangladeshi patients and assess the distribution of metabolic risk factors. Methods A cross-sectional study was carried out at Chattogram Medical College Hospital between March 2023 and June 2024. A total of 345 NAFLD patients and 135 healthy individuals were recruited. NAFLD was diagnosed using abdominal ultrasonography, and participants were assessed for obesity, hyperglycemia, hypertension, and dyslipidemia. Liver function tests, serum lipid profiles, and metabolic indicators were analyzed. Statistical comparisons and logistic regression were used to evaluate associations ( p < 0.05 considered significant). Results Among NAFLD patients, 62.5% were obese, 58% had high blood sugar, and 46% were hypertensive. Compared to healthy controls, patients showed significantly elevated liver enzymes, including ALT (112.7 ± 27 vs. 28.29 ± 4.84 IU/L; p < 0.0001) and AST (72.98 ± 9.5 vs. 35.28 ± 7.30 IU/L; p < 0.0001). Obesity (OR = 2.21, 95% CI: 1.32–3.72) and hyperglycemia (OR = 2.55, 95% CI: 1.45–4.50) were significantly linked to disease severity. Interestingly, nearly one-fourth of patients showed no major metabolic risk factors. Conclusion While NAFLD in Bangladesh is strongly tied to obesity and high blood sugar, a notable subset of patients lacks classic metabolic traits. These findings call for inclusive screening strategies and early lifestyle interventions to prevent disease progression.