You are here: Home Publications 2016 Screening diabetic patients for non-Alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: A prospective cohort study

Kwok Raymond, Choi Kai Chow, Wong Grace Lai Hung, Zhang Yuying, Chan Henry Lik Yuen, Luk Aandrea On Yan, Shu Sally She Ting, Chan Anthony Wing Hung, Yeung Ming Wai, Chan Juliana Chung Ngor, and Kong Alice Pik Shan (2016)

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

Gut, 65(8):1359–1368.

Objective 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., Copyright © 2016 Published by the BMJ Publishing Group Limited.

*controlled attenuation parameter, *digestive system disease assessment, *elastograph, *liver stiffness measurement, *non insulin dependent diabetes mellitus/dt [Drug, *nonalcoholic fatty liver, adult, alanine aminotransferase/ec [Endogenous Compound], albumin/ec [Endogenous Compound], article, body mass, cohort analysis, creatinine/ec [Endogenous Compound], disease duration, elastography, fatty liver, female, glucose blood level, glucose/ec [Endogenous Compound], high density lipoprotein cholesterol/ec [Endogenou, human, human tissue, insulin/dt [Drug Therapy], liver biopsy, liver fibrosis, major clinical study, male, non insulin dependent diabetes mellitus/dt [Drug T, priority journal, prospective study, risk factor, sex difference, triacylglycerol/ec [Endogenous Compound] XT - non
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