Background: Nonalcoholic fatty liver (NAFLD) is emerging as a major health problem worldwide. An association between insulin resistant and obesity is confirmed. However, the relation between them and NAFLD has not been elucidated with non diabetic normal healthy subjects. The aim: Is to evaluate the use of simple biomarkers as predictors for NAFLD. Patients and Methods: Seventy seven Saudi Subjects divided into two groups: Group( 1) included 37 patients, 14 females and 23 males, known to have diabetes mellitus type 2 with age range of 42-59 years. Group( 2) included 40 healthy subjects who have no medical illness. The investigations were done for both groups, BMI, liver function tests, triglycerides, cholesterol, fasting blood sugar, fasting insulin, insulin resistance (HOMA-IR), leptin and abdominal ultrasonography. Results: There was a statistical significant difference for all laboratory parameters between both groups except for total bilirubin, direct bilirubin and ALT/AST ratio. In DM group patients with fatty liver was diagnosed in 22/37(54%) by abdominal ultrasound. The median values of TG, insulin, leptin, insulin resistant, ALT ,GGT,AST and ALT/AST ratio in diabetic patients were statistically significant higher in those with fatty liver compared with those without fatty liver (P values 0.05) In group 2 fatty liver was diagnosed by abdominal ultrasound in 12/40( 30%). The median values of FBS,TG, cholesterol, insulin, leptin, insulin resistant, ALT ,GGT,AST and ALT/AST ratio in the healthy subjects were statistically significant higher in those with fatty liver compared with those without fatty liver (P values 0.05).The sensitivity and specificity of GGT, ALT/AST ratio was as follow 100.%, 59% and 73%, 55% cut off value of 45 IU/l and 1.9 respectively. Conclusion: Elevated liver enzymes, although in normal ranges, at upper quartiles play a role in early diagnosis of fat overflow to the liver in addition to the other markers and abdominal ultrasound has a predictive value in early diagnosis of fatty liver.

combination and patients may require intensive care unit (ICU) treatment. Therefore, it seems necessary to identify prognostic clinical parameters and risk factors at the time of ICU admission. Aim of the study: To estimate the frequency of mortality and cirrhosis morbidity among patients with end stage liver disease (ESLD) admitted to the ICU and to evaluate the relation between demographic, clinical and laboratory data (potential risk factors) of those patients and mortality.Methods:120 patients with ESLD were enrolled [102 males (85%) and 18 females (15%)].History,clinical examination,full investigations and classification of patients according to Child-Turcotte-Pugh (CTP) and Model for end stage liver disease(MELD)score were done. Results: Regarding clinical presentation, hepatic encephalopathy (HE) was found in 87.5%, jaundice (60%), hematemesis (41.7%), hepatorenal syndrome (HRS)( 35.8%) and spontaneous bacterial peritonitis (SBP)(20.8%). Mortality rate was 57.5%; the main causes of death were HRS (40.8%), HE (21.7), aspiration pneumonia (10%), septic shock (2.5%) and irreversible shock in only 1.7%. There was a significant relation between mortality and old age, CTP and MELD scores and a longer stay at the ICU. Increased white blood cell count, increased hemoglobin and decreased prothrombin concentration and raised creatinine were independent risk factors of mortality in ESLD patients in the ICU. Mortality rates were higher(86.2%) with 5-6 risk factors and (21.7%) with 1-2 risk factor(s).Conclusions: Mortality rate in ESLD patients admitted to ICU was 57.5% and the most common cause of death was HRS. CTP, MELD score, HE, HRS and jaundice were significant predictors of mortality in ESLD patients. Mortality increased with increased number of risk factors. Creatinine level, white blood cell count, hemoglobin and prothrombin concentration were independent risk factors of mortality in ESLD patients

combination and patients may require intensive care unit (ICU) treatment. Therefore, it seems necessary to identify prognostic clinical parameters and risk factors at the time of ICU admission. Aim of the study: To estimate the frequency of mortality and cirrhosis morbidity among patients with end stage liver disease (ESLD) admitted to the ICU and to evaluate the relation between demographic, clinical and laboratory data (potential risk factors) of those patients and mortality.Methods:120 patients with ESLD were enrolled [102 males (85%) and 18 females (15%)].History,clinical examination,full investigations and classification of patients according to Child-Turcotte-Pugh (CTP) and Model for end stage liver disease(MELD)score were done. Results: Regarding clinical presentation, hepatic encephalopathy (HE) was found in 87.5%, jaundice (60%), hematemesis (41.7%), hepatorenal syndrome (HRS)( 35.8%) and spontaneous bacterial peritonitis (SBP)(20.8%). Mortality rate was 57.5%; the main causes of death were HRS (40.8%), HE (21.7), aspiration pneumonia (10%), septic shock (2.5%) and irreversible shock in only 1.7%. There was a significant relation between mortality and old age, CTP and MELD scores and a longer stay at the ICU. Increased white blood cell count, increased hemoglobin and decreased prothrombin concentration and raised creatinine were independent risk factors of mortality in ESLD patients in the ICU. Mortality rates were higher(86.2%) with 5-6 risk factors and (21.7%) with 1-2 risk factor(s).Conclusions: Mortality rate in ESLD patients admitted to ICU was 57.5% and the most common cause of death was HRS. CTP, MELD score, HE, HRS and jaundice were significant predictors of mortality in ESLD patients. Mortality increased with increased number of risk factors. Creatinine level, white blood cell count, hemoglobin and prothrombin concentration were independent risk factors of mortality in ESLD patients