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

Abstract

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.

• Authors: Jasbir Makker, Hassan Tariq, Kishore Kumar, Madhavi Ravi, Danial Haris Shaikh, Vivien Leung, Umar Hayat, Muhammad T Hassan, Harish Patel, Suresh Nayudu, Sridhar Chilimuri
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 27 Issue 6 Pg. 523-533 (Feb 14 2021) ISSN: 2219-2840 [Electronic] United States
• PMID: 33642826 (Publication Type: Journal Article)
• Copyright: ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

Chemical References

• Transaminases

Topics

• Adult
• Diabetes Mellitus, Type 2 (complications, epidemiology)
• Humans
• Liver Cirrhosis (diagnostic imaging, epidemiology)
• Non-alcoholic Fatty Liver Disease (complications, diagnostic imaging, epidemiology)
• Prevalence
• Prospective Studies
• Transaminases