Research Article Details

Article ID: A12242
PMID: 30551263
Source: J Gastroenterol Hepatol
Title: Screening for non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus using transient elastography.
Abstract: BACKGROUND AND AIM: The recommendation in regard to screening for non-alcoholic fatty liver disease (NAFLD) among type 2 diabetes mellitus (T2DM) patients differs in major guidelines. The aim of this paper was to study the prevalence of NALFD and advanced fibrosis among T2DM patients. METHODS: This is a cross-sectional study of consecutive adult T2DM patients attending the Diabetes Clinic of a university hospital. Significant hepatic steatosis and advanced fibrosis was diagnosed based on transient elastography if the controlled attenuation parameter was &#8805;&#160;263&#160;dB/m, and the liver stiffness measurement was &#8805;&#160;9.6&#160;kPa using the M probe or &#8805;&#160;9.3&#160;kPa using the XL probe, respectively. Patients with liver stiffness measurement &#8805;&#160;8&#160;kPa were referred to the Gastroenterology and Hepatology Clinic for further assessment, including liver biopsy. RESULTS: The data of 557 patients were analyzed (mean age 61.4&#160;&#177;&#160;10.8&#160;years, male 40.6%). The prevalence of NAFLD and advanced fibrosis based on transient elastography was 72.4% and 21.0%, respectively. On multivariate analysis, independent factors associated with NAFLD were central obesity (OR 4.856, 95% confidence interval [CI] 2.749-8.577, P&#160;=&#160;0.006), serum triglyceride (OR 1.585, 95% CI 1.056-2.381, P&#160;=&#160;0.026), and alanine aminotransferase levels (OR 1.047, 95% CI 1.025-1.070, P&#160;<&#160;0.001) while advanced fibrosis was associated with serum high-density lipoprotein cholesterol (OR 0.355, 95% CI 0.126-0.997, P&#160;=&#160;0.049), alanine aminotransferase (OR 1.023, 95% CI 1.009-1.037, P&#160;=&#160;0.001), &#947;-glutamyltransferase (OR 1.005, 95% CI 1.001-1.008, P&#160;=&#160;0.017), and platelet levels (OR 0.995, 95% CI 0.992-0.999, P&#160;=&#160;0.010). Seventy-one patients underwent liver biopsy. The majority had non-alcoholic steatohepatitis (83.1%) and &#8805;&#160;F1 fibrosis (87.3%) while advanced fibrosis was seen in 36.6%. CONCLUSION: The prevalence of NAFLD and advanced fibrosis based on transient elastography is high among T2DM patients.
DOI: 10.1111/jgh.14577