Dominique Roulot1, Françoise Roudot-Thoraval2, Gisele NKontchou3, Narcisse Kouacou4, Jean-Luc Costes4, Ghassan Elourimi1, Hervé Le Clesiau4, Marianne Ziol5, Michel Beaugrand3. 1. Department of Hepatology, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Paris 13 University, Sorbonne Paris Cité, UFR SMBH, Bobigny, France. 2. Department of Public Health, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est-Créteil University, Créteil, France. 3. Department of Hepatogastroenterology, Jean Verdier Hospital, Assistance Publique-Hôpitaux de Paris, Paris 13 University, Sorbonne Paris Cité, Bobigny, France. 4. Social Medical Center, Bobigny, France. 5. Department of Anatomopathology, Jean Verdier Hospital, Assistance Publique-Hôpitaux de Paris, Paris 13 University, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
Abstract
BACKGROUND: Type 2 diabetes is a risk factor for steatohepatitis and fibrosis. Non-invasive liver stiffness (LS) and controlled attenuation parameter (CAP) measurements by Fibroscan allow assessing liver fat and fibrosis. AIM: To determine the prevalence of steatosis and significant fibrosis in a community-based diabetic population. METHODS: LS and CAP were measured in 705 patients using the standard "M probe." A second "XL probe" was used, without CAP measurement, in case of failure with the "M probe." RESULTS: LS and CAP measurements were obtained in 437 patients (the M group), LS measurements (LSM) with the XL probe being available in additional 232 patients. After the combined use of both probes, LSM failure and unreliable result were 1.6% and 5.6% respectively. Overall, 12.7% (n=85), 7.3% and 2.1% exhibited significant or advanced fibrosis or cirrhosis (LSM≥8 kPa, ≥9.6 kPa, ≥13 kPa respectively), half of the patients with LSM≥8 kPa displayed normal liver tests. Significant and severe steatosis were measured in 75% and 24% of the M group patients. By multivariate analysis, factors associated with severe fibrosis were age, overweight, high GGT. Forty-seven patients with LSM≥8 kPa underwent liver biopsy; 93% had steatosis and 51% severe fibrosis. A significant correlation was found between LSM values and fibrosis score with an accuracy rate of 83%, 68% and 83% for LSM≥8 kPa, ≥9.6 kPa and ≥13 kPa respectively. CONCLUSIONS: The prevalence of significant steatosis is very high and significant fibrosis affect 12.7% of the patients. Fibroscan is an effective procedure to screen for fibrosis and steatosis in diabetic patients.
BACKGROUND:Type 2 diabetes is a risk factor for steatohepatitis and fibrosis. Non-invasive liver stiffness (LS) and controlled attenuation parameter (CAP) measurements by Fibroscan allow assessing liver fat and fibrosis. AIM: To determine the prevalence of steatosis and significant fibrosis in a community-based diabetic population. METHODS: LS and CAP were measured in 705 patients using the standard "M probe." A second "XL probe" was used, without CAP measurement, in case of failure with the "M probe." RESULTS: LS and CAP measurements were obtained in 437 patients (the M group), LS measurements (LSM) with the XL probe being available in additional 232 patients. After the combined use of both probes, LSM failure and unreliable result were 1.6% and 5.6% respectively. Overall, 12.7% (n=85), 7.3% and 2.1% exhibited significant or advanced fibrosis or cirrhosis (LSM≥8 kPa, ≥9.6 kPa, ≥13 kPa respectively), half of the patients with LSM≥8 kPa displayed normal liver tests. Significant and severe steatosis were measured in 75% and 24% of the M group patients. By multivariate analysis, factors associated with severe fibrosis were age, overweight, high GGT. Forty-seven patients with LSM≥8 kPa underwent liver biopsy; 93% had steatosis and 51% severe fibrosis. A significant correlation was found between LSM values and fibrosis score with an accuracy rate of 83%, 68% and 83% for LSM≥8 kPa, ≥9.6 kPa and ≥13 kPa respectively. CONCLUSIONS: The prevalence of significant steatosis is very high and significant fibrosis affect 12.7% of the patients. Fibroscan is an effective procedure to screen for fibrosis and steatosis in diabeticpatients.
Authors: PreyaJanubhai Patel; Fabrina Hossain; Leigh Ula Horsfall; Xuan Banh; Kelly Lee Hayward; Suzanne Williams; Tracey Johnson; Anne Bernard; Nigel Neil Brown; Guy Lampe; Lyndall Buck; Nivene Saad; Anthony William Russell; Patricia Casarolli Valery; Katharine Margaret Irvine; Andrew Donald Clouston; Katherine Anne Stuart; William Rosenberg; Elizabeth Ellen Powell Journal: Hepatol Commun Date: 2018-08-06
Authors: Omar A Saldarriaga; Bradley Dye; Judy Pham; Timothy G Wanninger; Daniel Millian; Michael Kueht; Benjamin Freiberg; Netanya Utay; Heather L Stevenson Journal: Sci Rep Date: 2021-07-15 Impact factor: 4.379