High prevalence of hepatic steatosis and hepatic fibrosis in patients with type 2 diabetes mellitus

Gupta, Aanchal; Anoop, Shajith; Ansari, Irshad Ahmad; Prakash, Sadguru; Misra, Anoop

doi:10.1016/j.clnesp.2021.08.028

Cited by 19 publications

(4 citation statements)

References 20 publications

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“…Apart from a few studies from North India 40 and Vietnam, 41 there are no reports of VCTE data in patients with diabetes from Asia. There are no data on VCTE from Sri Lanka.…”

Section: Discussionmentioning

confidence: 99%

Identification of patients with type 2 diabetes with non-alcoholic fatty liver disease who are at increased risk of progressing to advanced fibrosis: a cross-sectional study

et al. 2023

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IntroductionIdentification of advanced hepatic fibrosis in non-alcoholic fatty liver disease (NAFLD) is important as this may progress to cirrhosis and hepatocellular carcinoma. The risk of hepatic fibrosis is especially high among patients with diabetes with NAFLD. Annual screening of patients with diabetes for fatty liver and calculation of Fibrosis-4 (FIB-4) score and exclusion of significant fibrosis with vibration-controlled transient elastography (VCTE) have been recommended. However, VCTE is expensive and may not be freely available in resource-limited settings. We aim to identify predictors of significant liver fibrosis who are at increased risk of progression to advanced liver fibrosis and to develop a prediction model to prioritise referral of patients with diabetes and NAFLD for VCTE.Methods and analysisThis cross-sectional study is conducted among all consenting adults with type 2 diabetes mellitus with NAFLD at the Colombo North Teaching Hospital, Ragama, Sri Lanka. All patients get the FIB-4 score calculated. Those with FIB-4 ≥1.3 undergo VCTE (with FibroScan by Echosens). Risk associations for progression to advanced liver fibrosis/cirrhosis will be identified by comparing patients with significant fibrosis (liver stiffness measure (LSM) ≥8 kPa) and without significant fibrosis (LSM <8 kPa). A model to predict significant liver fibrosis will be developed using logistic regression.Ethics and disseminationEthical approval has been obtained from the Ethics Committee of the Faculty of Medicine, University of Kelaniya (P/66/07/2021). Results of the study will be disseminated as scientific publications in reputable journals.

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“…Apart from a few studies from North India 40 and Vietnam, 41 there are no reports of VCTE data in patients with diabetes from Asia. There are no data on VCTE from Sri Lanka.…”

Section: Discussionmentioning

confidence: 99%

Identification of patients with type 2 diabetes with non-alcoholic fatty liver disease who are at increased risk of progressing to advanced fibrosis: a cross-sectional study

et al. 2023

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“…Albumin levels are not routinely measured in the study population, and we were therefore unable to calculate the NAFLD fibrosis score. Furthermore, we were unable to pull data from the EMR concerning the duration of T2DM, which affects the risk of developing liver disease [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Non-alcoholic fatty liver disease in patients with type 2 diabetes in Greenland: a register-based cross-sectional study

Muhammad

Hansen

Gantzel

et al. 2022

International Journal of Circumpolar Health

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Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide due to its close association to the metabolic syndrome of type 2 diabetes mellitus (T2DM), obesity and insulin resistance. However, the prevalence and severity of NAFLD in Greenland remain unexplored. We aimed to estimate the prevalence of liver steatosis and fibrosis among Greenlanders and Danes with T2DM living in Greenland using biochemical surrogate markers. We included 1409 Greenlanders and 182 Danes with T2DM in this register-based cross-sectional study. Greenlanders had higher BMI and plasma lipid levels and lower HbA1c levels compared with Danes (p<0.05). Their median alanine aminotransferase (ALAT) levels were similar. However, more Greenlanders had elevated ALAT levels (20.5% vs. 11.5%, p<0.05). Greenlanders had lower FIB-4 scores than Danes, 0.91 (IQR: 0.66–1.27) vs. 0.97 (IQR: 0.78–1.34), without difference in FIB-4 score categories (p=0.27). The prevalence of advanced fibrosis was low in both populations (1.7–2.6%). In conclusion, Greenlanders with T2DM had better glycaemic control despite higher BMI and plasma lipids. A larger proportion of Greenlanders had elevated plasma ALAT levels, while FIB-4 scores were lower than Danes. These findings suggest that Greenlanders with T2DM may be less likely to develop liver complications than Danes with T2DM in Greenland.

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“…However, current guidelines do not yet recommend it as a standard routine method to identify NAFLD among asymptomatic, even though high-risk, populations [ 9 ]. It is noteworthy that a large number of studies overestimated the grade of hepatic fat by using lower, inappropriate CAP cut-offs, as described in Table 4 [ 75 , 76 , 83 , 89 , 90 ].…”

Section: Ultrasound-based Hepatic Shear Wave Elastographymentioning

confidence: 99%

Ultrasound-Based Hepatic Elastography in Non-Alcoholic Fatty Liver Disease: Focus on Patients with Type 2 Diabetes

et al. 2022

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Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease and is the hepatic expression of metabolic syndrome. The development of non-invasive methods for the diagnosis of hepatic steatosis and advanced fibrosis in high-risk patients, especially those with type 2 diabetes mellitus, is highly needed to replace the invasive method of liver biopsy. Elastographic methods can bring significant added value to screening and diagnostic procedures for NAFLD in patients with diabetes, thus contributing to improved NAFLD management. Pharmacological development and forthcoming therapeutic measures that address NAFLD should also be based on new, non-invasive, and reliable tools that assess NAFLD in at-risk patients and be able to properly guide treatment in individuals with both diabetes and NAFLD. This is the first review aiming to outline and discuss recent studies on ultrasound-based hepatic elastography, focusing on NAFLD assessment in patients with diabetes.

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High prevalence of hepatic steatosis and hepatic fibrosis in patients with type 2 diabetes mellitus

Cited by 19 publications

References 20 publications

Identification of patients with type 2 diabetes with non-alcoholic fatty liver disease who are at increased risk of progressing to advanced fibrosis: a cross-sectional study

Identification of patients with type 2 diabetes with non-alcoholic fatty liver disease who are at increased risk of progressing to advanced fibrosis: a cross-sectional study

Non-alcoholic fatty liver disease in patients with type 2 diabetes in Greenland: a register-based cross-sectional study

Ultrasound-Based Hepatic Elastography in Non-Alcoholic Fatty Liver Disease: Focus on Patients with Type 2 Diabetes

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