Ivica Grgurevic1, Nermin Salkic2, Sanda Mustapic1, Tomislav Bokun1, Kristian Podrug3, Srecko Marusic4, Dario Rahelic5,6, Tomas Matic5, Viktoria Skurla7, Ivana Mikolasevic8. 1. Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, University of Zagreb School of Medicine and Faculty of Pharmacy and Biochemistry, Zagreb, Croatia. 2. Department of Gastroenterology and Hepatology, University Hospital Centre Tuzla, Tuzla, Bosnia and Herzegovina. 3. Department of Gastroenterology and Hepatology, University Hospital Split, Split, Croatia. 4. Department of Endocrinology, Diabetes and Metabolism, University Hospital Dubrava, University of Zagreb School of Medicine and Faculty of Pharmacy and Biochemistry, Zagreb, Croatia. 5. Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, University of Zagreb School of Medicine, Zagreb, Croatia. 6. School of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia. 7. University of Zagreb School of Medicine, Zagreb, Croatia. 8. Department of Gastroenterology and Hepatology, University Hospital Merkur, Zagreb, Croatia.
Abstract
Aims: To investigate morbidity and mortality in a real-life cohort of patients with type 2 diabetes (T2D) in relation to prevalence and severity of nonalcoholic fatty liver disease (NAFLD). Methods: Patients with T2D were referred for assessment of liver fibrosis by the FIB-4 test and liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE). Liver steatosis was quantified by the controlled attenuation parameter (CAP). These patients were followed until death or censored date. Results: Among 454 patients (52% males, mean age 62.5 years, BMI 30.9 kg/m2), 82.6% was overweight, 77.8% had fatty liver, and 9.9% and 3.1% had LSM and FIB-4 values suggestive of advanced fibrosis, respectively. During the follow-up period of median 2 years, 106 (23%) patients experienced adverse event (11% cardiovascular) and 17 (3.7%) died, whereas no liver-related morbidity or mortality was observed. Independent predictors of adverse outcomes were age and higher platelet count, while FIB-4, LSM, and CAP were not. Conclusion: In a cohort of T2D patients, no liver-related morbidity or mortality occurred during 2 years. Our patients probably have low real prevalence of advanced fibrosis which is likely overestimated by LSM ≥ 9.6 kPa. Liver fibrosis may be safely reassessed in the 2 years interval in noncirrhotic patients with T2D.
Aims: To investigate morbidity and mortality in a real-life cohort of patients with type 2 diabetes (T2D) in relation to prevalence and severity of nonalcoholic fatty liver disease (NAFLD). Methods:Patients with T2D were referred for assessment of liver fibrosis by the FIB-4 test and liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE). Liver steatosis was quantified by the controlled attenuation parameter (CAP). These patients were followed until death or censored date. Results: Among 454 patients (52% males, mean age 62.5 years, BMI 30.9 kg/m2), 82.6% was overweight, 77.8% had fatty liver, and 9.9% and 3.1% had LSM and FIB-4 values suggestive of advanced fibrosis, respectively. During the follow-up period of median 2 years, 106 (23%) patients experienced adverse event (11% cardiovascular) and 17 (3.7%) died, whereas no liver-related morbidity or mortality was observed. Independent predictors of adverse outcomes were age and higher platelet count, while FIB-4, LSM, and CAP were not. Conclusion: In a cohort of T2D patients, no liver-related morbidity or mortality occurred during 2 years. Our patients probably have low real prevalence of advanced fibrosis which is likely overestimated by LSM ≥ 9.6 kPa. Liver fibrosis may be safely reassessed in the 2 years interval in noncirrhotic patients with T2D.
Authors: Sae Kyung Joo; Won Kim; Donghee Kim; Jung Ho Kim; Sohee Oh; Kook Lae Lee; Mee Soo Chang; Yong Jin Jung; Young Ho So; Myoung Seok Lee; Jeong Mo Bae; Byeong Gwan Kim Journal: Liver Int Date: 2017-09-05 Impact factor: 5.828
Authors: Fasiha Kanwal; Jennifer R Kramer; Srikar Mapakshi; Yamini Natarajan; Maneerat Chayanupatkul; Peter A Richardson; Liang Li; Roxanne Desiderio; Aaron P Thrift; Steven M Asch; Jinna Chu; Hashem B El-Serag Journal: Gastroenterology Date: 2018-08-23 Impact factor: 22.682
Authors: Peter J Eddowes; Magali Sasso; Michael Allison; Emmanouil Tsochatzis; Quentin M Anstee; David Sheridan; Indra N Guha; Jeremy F Cobbold; Jonathan J Deeks; Valérie Paradis; Pierre Bedossa; Philip N Newsome Journal: Gastroenterology Date: 2019-01-25 Impact factor: 22.682
Authors: Vincent Wai-Sun Wong; Julien Vergniol; Grace Lai-Hung Wong; Juliette Foucher; Henry Lik-Yuen Chan; Brigitte Le Bail; Paul Cheung-Lung Choi; Mathurin Kowo; Anthony Wing-Hung Chan; Wassil Merrouche; Joseph Jao-Yiu Sung; Victor de Lédinghen Journal: Hepatology Date: 2010-02 Impact factor: 17.425
Authors: Claudia R L Cardoso; Cristiane A Villela-Nogueira; Nathalie C Leite; Gil F Salles Journal: Cardiovasc Diabetol Date: 2021-09-24 Impact factor: 9.951