Screening diabetic patients for non-Alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: A prospective cohort study
Publication in refereed journal

替代計量分析
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其它資訊
摘要Type 2 diabetes is an important risk factor for non-alcoholic fatty liver disease (NAFLD), but current guidelines provide conflicting recommendations on whether diabetic patients should be screened for NAFLD. We therefore studied the strategy of screening diabetic patients by FibroScan.

DESIGN:
Liver fat and fibrosis were assessed by controlled attenuation parameter (CAP) and liver stiffness measurements (LSM) by FibroScan at a diabetic centre for patients from primary care and hospital clinics. Probe-specific LSM cut-offs were used to detect advanced fibrosis.

RESULTS:
Of 1918 patients examined, 1799 (93.8%) had valid CAP and 1884 (98.2%) had reliable LSM (1770 with the M probe and 114 with the XL probe). The proportion of patients with increased CAP and LSM was 72.8% (95% CI 70.7% to 74.8%) and 17.7% (95% CI 16.0% to 19.5%), respectively. By multivariable analysis, female gender, higher body mass index, triglycerides, fasting plasma glucose and alanine aminotransferase (ALT) and non-insulin use were associated with increased CAP. Longer duration of diabetes, higher body mass index, increased ALT and spot urine albumin:creatinine ratio and lower high-density lipoprotein-cholesterol were associated with increased LSM. Ninety-four patients (80% had increased LSM) underwent liver biopsy: 56% had steatohepatitis and 50% had F3-4 disease.

CONCLUSIONS:
Diabetic patients have a high prevalence of NAFLD and advanced fibrosis. Those with obesity and dyslipidaemia are at particularly high risk and may be the target for liver assessment. Our data support screening for NAFLD and/or advanced fibrosis in patients with type 2 diabetes.
著者Kwok R., Choi K.C., Wong G.L.-H., Zhang Y., Chan H.L.-Y., Luk A.O.-Y., Shu S.S.-T., Chan A.W.-H., Yeung M.-W., Chan J.C.-N., Kong A.P.-S., Wong V.W.-S.
期刊名稱Gut
出版年份2016
月份8
卷號65
期次8
出版社BMJ Publishing Group
出版地United Kingdom
頁次1359 - 1368
國際標準期刊號0017-5749
電子國際標準期刊號1468-3288
語言英式英語

上次更新時間 2020-23-11 於 01:21