Screening for hepatic fibrosis and steatosis in Turkish patients with type 2 diabetes mellitus: A transient elastography study

Demir, Meryem; Deyneli, Oğuzhan; Yılmaz, Yusuf

doi:10.5152/tjg.2018.18559

Cited by 23 publications

(25 citation statements)

References 21 publications

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“…VCTE and CAP are good methods for NASH screening, but, probably, new ultrasound systems able to quantify steatosis and fibrosis severity by different elastography techniques, would be even more accurate. This paper is in line with a Turkish study [7] that included 124 T2DM patients. The prevalence rates of obesity were similar (64.5% vs. 61.2%, p = 0.5), and in both studies, approximately 20% of patients had at least advanced fibrosis.…”

Section: Discussionsupporting

confidence: 83%

“…Also, in a larger Dutch cohort [19], higher LSM were strongly associated with steatosis and T2DM. These three studies [6,7,19] showed that diabetic patients are at high risk for steatosis and significant fibrosis. The differences in the prevalence among the three groups can be explained by the different prevalence of obesity among the groups and by the quality of diabetes control.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study showed that the prevalence of NAFLD in type 2 diabetes is approximately 60% [5]. Other studies from France and Turkey showed that the presence of fibrosis is high in these subjects [6,7].…”

Section: Introductionmentioning

confidence: 98%

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Screening for Liver Fibrosis and Steatosis in a Large Cohort of Patients with Type 2 Diabetes Using Vibration Controlled Transient Elastography and Controlled Attenuation Parameter in a Single-Center Real-Life Experience

Sporea

Mare

Popescu

et al. 2020

JCM

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Background: Type 2 diabetes mellitus (T2DM), obesity, hyperlipidemia, and hypertension are considered risk factors for developing non-alcoholic fatty liver disease (NAFLD). This study aims to assess steatosis and fibrosis severity in a cohort of T2DM patients, using vibration controlled transient elastography (VCTE) and controlled attenuation parameter (CAP). Material and method:We performed a prospective study in which, in each patient, we aimed for 10 valid CAP and liver stiffness measurements (LSM). To discriminate between fibrosis stages, we used the following VCTE cut-offs: F ≥ 2-8.2 kPa, F ≥ 3-9.7 kPa, and F4 -13.6 kPa. To discriminate between steatosis stages, we used the following CAP cut-offs: S1 (mild) -274 dB/m, S2 (moderate) -290dB/m, S3 (severe) -302dB/m. Results: During the study period, we screened 776 patients; 60.3% had severe steatosis, while 19.4% had advanced fibrosis. Female gender, BMI, waist circumference, elevated levels of AST, total cholesterol, triglycerides, blood glucose, and high LSM were associated with severe steatosis (all p-value < 0.05). BMI, waist circumference, elevated levels of AST, HbA1c, and CAP were associated with advanced fibrosis (all p-values < 0.05). Conclusion: Higher BMI (obesity) comprises a higher risk of developing severe steatosis and fibrosis. Individualized screening strategies should be established for NAFLD according to different BMI.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Screening for Liver Fibrosis and Steatosis in a Large Cohort of Patients with Type 2 Diabetes Using Vibration Controlled Transient Elastography and Controlled Attenuation Parameter in a Single-Center Real-Life Experience

Sporea

Mare

Popescu

et al. 2020

JCM

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“…In a CAP study conducted using Fibroscan with 124 patients with T2DM (mean age 53±7 years) in Turkey, 94.3% of the patients were diagnosed with NAFLD. In the study population, 64.5% was obese, 28.2% overweight, and 77.4% had MS (30). Likewise, in prediabetics, there is a tendency to develop NAFLD as frequently as in diabetics.…”

Section: Non-alcoholic Fatty Liver Disease and Its Association With Omentioning

confidence: 87%

Non-alcoholic fatty liver disease: A growing public health problem in Turkey

Kaya

Yılmaz

2019

Turk J Gastroenterol

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Non-alcoholic fatty liver disease (NAFLD) is histologically classified as either non-alcoholic fatty liver or non-alcoholic steatohepatitis (NASH). NASH is the progressive subtype of NAFLD. Individuals with NASH are at significant risk of developing hepatic fibrosis, cirrhosis, hepatocellular carcinoma, and liver-related and all-cause mortality. NAFLD is closely associated with obesity, type 2 diabetes mellitus (T2DM), metabolic syndrome, and cardiovascular events. Its prevalence is estimated to be above 30% in Turkey; and recent studies confirm this estimate. According to these studies, the prevalence of NAFLD in Turkey is between 48.3% and 60.1%. Currently, Turkey can be considered a risky region in terms of NAFLD burden as it is the most obese country in Europe with an obesity prevalence of 32.1% according to the 2016 World Health Organization data. Moreover, along with the increasing prevalence of obesity and T2DM in Turkey, the burden of NAFLD is estimated to increase in the upcoming decade. Despite the growing burden, we lack well-designed systemic studies that investigate NAFLD and its marked histological severity. In this review, we present studies on the burden of NAFLD and NASH, the natural history of NAFLD, and its association with other systemic diseases conducted with Turkish populations.

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“…A Turkish study found prevalence of advanced fibrosis of 16.9% and cirrhosis of 8% in their patients with T2DM. The mean ALT in their patients with F3 fibrosis was 39 U/L[ 19 ]. In a large prospective cohort study from Hong Kong involving 1918 patients with T2DM, increased liver stiffness suggestive of F3 or F4 fibrosis was found in 18.8% of their diabetic patients with normal ALT, defined as ALT less than 30 U/L in men and less than 19 U/L in women.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of advanced liver fibrosis and steatosis in type-2 diabetics with normal transaminases: A prospective cohort study

Makker¹,

Tariq²,

Kumar³

et al. 2021

WJG

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BACKGROUND Nonalcoholic fatty liver disease (NAFLD) and type-2 diabetes mellitus (T2DM) have an intricate bidirectional relationship. Individuals with T2DM, not only have a higher prevalence of non-alcoholic steatosis, but also carry a higher risk of progression to nonalcoholic steatohepatitis. Experts still differ in their recommendations of screening for NAFLD among patients with T2DM. AIM To study the prevalence of NAFLD and advanced fibrosis among our patient population with T2DM. METHODS During the study period (November 2018 to January 2020), 59 adult patients with T2DM and 26 non-diabetic control group individuals were recruited prospectively. Patients with known significant liver disease and alcohol use were excluded. Demographic data and lab parameters were recorded. Liver elastography was performed in all patients. RESULTS In the study group comprised of patients with T2DM and normal alanine aminotransferase levels (mean 17.8 ± 7 U/L), 81% had hepatic steatosis as diagnosed by elastography. Advanced hepatic fibrosis (stage F3 or F4) was present in 12% of patients with T2DM as compared to none in the control group. Patients with T2DM also had higher number of individuals with grade 3 steatosis [45.8% vs 11.5%, ( P < 0.00001) and metabolic syndrome (84.7% vs 11.5%, P < 0.00001)]. CONCLUSION A significant number of patients with T2DM, despite having normal transaminase levels, have NAFLD, grade 3 steatosis and advanced hepatic fibrosis as measured by liver elastography.

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Screening for hepatic fibrosis and steatosis in Turkish patients with type 2 diabetes mellitus: A transient elastography study

Cited by 23 publications

References 21 publications

Screening for Liver Fibrosis and Steatosis in a Large Cohort of Patients with Type 2 Diabetes Using Vibration Controlled Transient Elastography and Controlled Attenuation Parameter in a Single-Center Real-Life Experience

Screening for Liver Fibrosis and Steatosis in a Large Cohort of Patients with Type 2 Diabetes Using Vibration Controlled Transient Elastography and Controlled Attenuation Parameter in a Single-Center Real-Life Experience

Non-alcoholic fatty liver disease: A growing public health problem in Turkey

Prevalence of advanced liver fibrosis and steatosis in type-2 diabetics with normal transaminases: A prospective cohort study

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