Identifying advanced MAFLD in a cohort of T2DM and clinical features.
MAFLD
NAFLD
NASH
T2DM
liver fibrosis
metabolic syndrome
obesity
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2023
2023
Historique:
received:
30
09
2022
accepted:
24
01
2023
entrez:
13
3
2023
pubmed:
14
3
2023
medline:
15
3
2023
Statut:
epublish
Résumé
MAFLD is the most common cause of chronic liver disease, affecting 25% of the global population. Patients with T2DM have an increased risk of developing MAFLD. In addition, patients with T2DM have a higher risk of advanced forms of steatohepatitis and fibrosis. Identifying those patients is critical in order to refer them to specialist and appropriate management of their disease. To estimate advanced fibrosis prevalence in a cohort of patients with T2DM and to identify possible predictors. subjects with T2DM during regular health check-up were enrolled. Demographic and general characteristics were measured, including metabolic parameters and homeostasis model assessment of insulin resistance (HOMA2-IR). Four non-invasive fibrosis scores (NAFLD fibrosis scores, FIB-4, APRI, Hepamet fibrosis score) were measure and compared with transient elastography (TE). 96 patients (21%) presented risk of significant fibrosis (≥F2) measured by TE and 45 patients (10%) presented with risk of advanced fibrosis F3-F4. Liver fibrosis was related to BMI, AC, HOMA2-IR. The results of the non-invasive fibrosis scores have been validated with the results obtained in the TE. It is observed that the index with the greatest area under the curve (AUC) is APRI (AUC=0.729), with a sensitivity of 62.2% and a specificity of 76.1%. However, the test with better positive likelihood ratio (LR+) in our study is NAFLD fibrosis score. Our results show that in a general T2DM follow up, 10% of patients were at risk of advanced fibrosis. We found a positive correlation between liver fibrosis and BMI, AC and HOMA2-IR. Non-invasive fibrosis markers can be useful for screening, showing NAFLD Fibrosis score a better LHR+ compared to TE. Further studies are needed to validate these results and elucidate the best screening approach to identify those patients at risk of advanced MAFLD.
Sections du résumé
Background
MAFLD is the most common cause of chronic liver disease, affecting 25% of the global population. Patients with T2DM have an increased risk of developing MAFLD. In addition, patients with T2DM have a higher risk of advanced forms of steatohepatitis and fibrosis. Identifying those patients is critical in order to refer them to specialist and appropriate management of their disease.
Aims and Objectives
To estimate advanced fibrosis prevalence in a cohort of patients with T2DM and to identify possible predictors.
Methods
subjects with T2DM during regular health check-up were enrolled. Demographic and general characteristics were measured, including metabolic parameters and homeostasis model assessment of insulin resistance (HOMA2-IR). Four non-invasive fibrosis scores (NAFLD fibrosis scores, FIB-4, APRI, Hepamet fibrosis score) were measure and compared with transient elastography (TE).
Results
96 patients (21%) presented risk of significant fibrosis (≥F2) measured by TE and 45 patients (10%) presented with risk of advanced fibrosis F3-F4. Liver fibrosis was related to BMI, AC, HOMA2-IR. The results of the non-invasive fibrosis scores have been validated with the results obtained in the TE. It is observed that the index with the greatest area under the curve (AUC) is APRI (AUC=0.729), with a sensitivity of 62.2% and a specificity of 76.1%. However, the test with better positive likelihood ratio (LR+) in our study is NAFLD fibrosis score.
Conclusions
Our results show that in a general T2DM follow up, 10% of patients were at risk of advanced fibrosis. We found a positive correlation between liver fibrosis and BMI, AC and HOMA2-IR. Non-invasive fibrosis markers can be useful for screening, showing NAFLD Fibrosis score a better LHR+ compared to TE. Further studies are needed to validate these results and elucidate the best screening approach to identify those patients at risk of advanced MAFLD.
Identifiants
pubmed: 36909342
doi: 10.3389/fendo.2023.1058995
pmc: PMC9992874
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1058995Informations de copyright
Copyright © 2023 Sanchez-Bao, Soto-Gonzalez, Delgado-Blanco, Balboa-Barreiro and Bellido.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Clin Diabetes Endocrinol. 2016 Apr 12;2:9
pubmed: 28702244
Medicine (Baltimore). 2015 Dec;94(48):e2159
pubmed: 26632897
Arterioscler Thromb Vasc Biol. 2022 Jun;42(6):e168-e185
pubmed: 35418240
J Gastroenterol Hepatol. 2019 Aug;34(8):1390-1395
pubmed: 30600551
J Clin Med. 2022 Mar 02;11(5):
pubmed: 35268466
Gut. 2011 Jul;60(7):977-84
pubmed: 21068129
Eur J Intern Med. 2017 Jun;41:74-78
pubmed: 28283346
Hepatology. 2006 Oct;44(4):865-73
pubmed: 17006923
Gastroenterology. 2020 May;158(7):1851-1864
pubmed: 32061595
Biometrics. 1988 Sep;44(3):837-45
pubmed: 3203132
Adv Exp Med Biol. 2021;1307:417-440
pubmed: 32424494
Ann Hepatol. 2008 Oct-Dec;7(4):350-7
pubmed: 19034235
Hepatology. 2007 Jul;46(1):32-6
pubmed: 17567829
FASEB J. 2020 Feb;34(2):2312-2325
pubmed: 31908001
Hepatology. 2013 Mar;57(3):1182-91
pubmed: 22899556
Diabetes Care. 2021 Feb;44(2):399-406
pubmed: 33355256
JGH Open. 2021 Jun 10;5(7):801-808
pubmed: 34263075
Clin Liver Dis (Hoboken). 2022 Jan 28;19(3):106-110
pubmed: 35355841
PLoS One. 2021 Apr 1;16(4):e0249223
pubmed: 33793621
J Hepatol. 2020 Jul;73(1):202-209
pubmed: 32278004
World J Gastroenterol. 2014 Jan 14;20(2):475-85
pubmed: 24574716
Nutr Hosp. 2022 Oct 17;39(5):1012-1018
pubmed: 36134588
J Hepatol. 2008 May;48(5):835-47
pubmed: 18334275
Med Clin (Barc). 2001 Nov 3;117(14):530-3
pubmed: 11707218
Diabetes Care. 2021 Feb;44(2):519-525
pubmed: 33303638
Hepatology. 2007 Apr;45(4):846-54
pubmed: 17393509
Gut. 2020 Jul;69(7):1343-1352
pubmed: 32066623
Clin Gastroenterol Hepatol. 2020 Jan;18(1):216-225.e5
pubmed: 31195161
Diabetologia. 1985 Jul;28(7):412-9
pubmed: 3899825
Endocr Pract. 2022 May;28(5):528-562
pubmed: 35569886
Hepatology. 2010 Feb;51(2):454-62
pubmed: 20101745