Ayurvedic Diagnostic Parameters in The Assessment of Non-Alcoholic Fatty Liver Disease (NAFLD): A Clinical Observational Study

Abstract

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is a common chronic liver disorder characterized by excessive accumulation of fat in the liver in individuals with no significant alcohol-related cause. It is strongly associated with obesity, insulin resistance, type 2 diabetes mellitus, dyslipidemia and sedentary lifestyle. Contemporary terminology increasingly uses the term Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), reflecting the metabolic basis of the condition. Ayurveda provides a comprehensive diagnostic methodology based on Nidana Panchaka, Dosha, Dushya, Agni, Ama, Srotas, Prakriti and Vikriti. Although there is no exact one-to-one classical equivalent of NAFLD, several Ayurvedic concepts may provide a useful framework for understanding metabolic disorders associated with hepatic steatosis. Aim: To assess the role of selected Ayurvedic diagnostic parameters in patients with NAFLD and to study their association with anthropometric, biochemical and ultrasonographic findings. Objectives: 1. To assess Prakriti and Vikriti in patients diagnosed with NAFLD. 2. To assess the status of Agni and clinical features suggestive of Ama. 3. To assess Meda Dushti and relevant Srotodushti features. 4. To study the relationship between Ayurvedic diagnostic parameters and BMI, waist circumference and metabolic parameters. 5. To assess the relationship between Ayurvedic parameters and ultrasonographic grading of fatty liver. 6. To explore the possibility of developing a standardized Ayurvedic diagnostic assessment framework for metabolic fatty liver disease. Methodology: A hospital-based observational clinical study may be conducted in adult patients diagnosed with fatty liver by ultrasonography. Patients may be assessed using a structured Ayurvedic diagnostic proforma covering Prakriti, Vikriti, Agni, Ama, Koshtha, Mala, Meda Dushti, Nidana and Srotodushti. Anthropometric parameters, liver function tests, fasting blood glucose, HbA1c, lipid profile and ultrasonographic findings may be recorded. Appropriate statistical tests may be applied to determine associations and correlations. Conclusion: An integrated assessment incorporating Ayurvedic diagnostic parameters and objective modern investigations may provide a useful research framework for studying metabolic fatty liver disease. However, Ayurvedic parameters should be validated prospectively before being considered independent diagnostic tools for NAFLD/MASLD.