Serial transient elastography examinations to monitor patients with type 2 diabetes: A prospective cohort study
Publication in refereed journal


摘要Type 2 diabetes is an important risk factor for nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis. Current international guidelines recommend the use of non-invasive tests as initial assessments for NAFLD, but the role of non-invasive tests as monitoring tools has not been established. We aimed to study the role of transient elastography as a monitoring tool in patients with type 2 diabetes. We recruited patients with type 2 diabetes without viral hepatitis or excessive alcohol intake from a complication screening facility in Hong Kong in 2013-2014 and repeated the assessments in 2016-2018. The primary endpoint was an increase of liver stiffness measurement (LSM) to ≥10 kPa. The secondary endpoint was the change in controlled attenuation parameter (CAP). 611 patients with type 2 diabetes and valid LSM (mean age 57.7±10.9 years; 342 males [56.0%]) were included in this study (568 also had valid CAP). Overall, there was moderate correlation between baseline and follow-up LSM (r=0.689, P<0.001). Among 487 patients with baseline LSM <10 kPa, 21 (4.3%) had follow-up LSM ≥10 kPa. Baseline body mass index, alanine aminotransferase (ALT) and ∆ALT were independent factors associated with LSM increase. Among 124 patients with baseline LSM ≥10 kPa, 70 (56.5%) had follow-up LSM <10 kPa. Among 198 patients with CAP <248 dB/m at baseline, 103 (52.0%) had CAP increased to ≥248 dB/m., Conclusion: The prevalence and incidence of NAFLD in patients with type 2 diabetes are high. Although advanced fibrosis is common in this population, few patients progress to advanced fibrosis in 3 years. Future studies should define the optimal surveillance interval in diabetic patients.
著者Lee HW, Wong GL, Kwok R, Choi KC, Chan CK, Shu SS, Leung JK, Chim AM, Luk AO, Ma RC, Chan HL, Chan JC, Kong AP, Wong VW

上次更新時間 2020-21-11 於 23:44