Screening for non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus using transient elastography
Background and Aim The recommendation in regard to screening for non‐alcoholic fatty liver disease (NAFLD) among type 2 diabetes mellitus (T2DM) patients differs in major guidelines. The aim of this paper was to study the prevalence of NALFD and advanced fibrosis among T2DM patients. Methods This is...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2019-08, Vol.34 (8), p.1396-1403 |
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| creator | Lai, Lee‐Lee Wan Yusoff, Wan Nur Illyana Vethakkan, Shireene Ratna Nik Mustapha, Nik Raihan Mahadeva, Sanjiv Chan, Wah‐Kheong |
| description | Background and Aim
The recommendation in regard to screening for non‐alcoholic fatty liver disease (NAFLD) among type 2 diabetes mellitus (T2DM) patients differs in major guidelines. The aim of this paper was to study the prevalence of NALFD and advanced fibrosis among T2DM patients.
Methods
This is a cross‐sectional study of consecutive adult T2DM patients attending the Diabetes Clinic of a university hospital. Significant hepatic steatosis and advanced fibrosis was diagnosed based on transient elastography if the controlled attenuation parameter was ≥ 263 dB/m, and the liver stiffness measurement was ≥ 9.6 kPa using the M probe or ≥ 9.3 kPa using the XL probe, respectively. Patients with liver stiffness measurement ≥ 8 kPa were referred to the Gastroenterology and Hepatology Clinic for further assessment, including liver biopsy.
Results
The data of 557 patients were analyzed (mean age 61.4 ± 10.8 years, male 40.6%). The prevalence of NAFLD and advanced fibrosis based on transient elastography was 72.4% and 21.0%, respectively. On multivariate analysis, independent factors associated with NAFLD were central obesity (OR 4.856, 95% confidence interval [CI] 2.749–8.577, P = 0.006), serum triglyceride (OR 1.585, 95% CI 1.056–2.381, P = 0.026), and alanine aminotransferase levels (OR 1.047, 95% CI 1.025–1.070, P |
| doi_str_mv | 10.1111/jgh.14577 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2157661204</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2280850056</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3537-5d2cb4a6399ec2abb8be50b65b50ca6db50e3e6067d92d2e1aaafacee15d0723</originalsourceid><addsrcrecordid>eNp1kc9u1DAQhy0Eokvh0BdAlnqBQ1rbiZ3Nsar6h6oSB3q3Js5k16usHWynbW48Qp-RJ8HLtj0gMZffYT59Gs2PkCPOTnie081qfcIrWddvyIJXFSt4Xam3ZMGWXBZNyZsD8iHGDWOsYrV8Tw5KJiUXqlyQxx8mIDrrVrT3gTrvfv96gsH4tR-soT2kNNPB3mOgnY0IEal1dIRk0aVIH2xa0zSPSEXeQ4sJI93iMNg0RTrFnTcFcHGHUxwgJr8KMK7nj-RdD0PET895SO4uL-7Or4vb71ffzs9uC1PKsi5kJ0xbgSqbBo2Atl22KFmrZCuZAdXlwBIVU3XXiE4gB4AeDCKXHatFeUi-7LVj8D8njElvbTT5QHDop6gFl7VSXLAqo8f_oBs_BZeP00Is2VIyJlWmvu4pE3yMAXs9BruFMGvO9K4NndvQf9vI7Odn49RusXslX96fgdM98GAHnP9v0jdX13vlH6wVlxs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2280850056</pqid></control><display><type>article</type><title>Screening for non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus using transient elastography</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Lai, Lee‐Lee ; Wan Yusoff, Wan Nur Illyana ; Vethakkan, Shireene Ratna ; Nik Mustapha, Nik Raihan ; Mahadeva, Sanjiv ; Chan, Wah‐Kheong</creator><creatorcontrib>Lai, Lee‐Lee ; Wan Yusoff, Wan Nur Illyana ; Vethakkan, Shireene Ratna ; Nik Mustapha, Nik Raihan ; Mahadeva, Sanjiv ; Chan, Wah‐Kheong</creatorcontrib><description>Background and Aim
The recommendation in regard to screening for non‐alcoholic fatty liver disease (NAFLD) among type 2 diabetes mellitus (T2DM) patients differs in major guidelines. The aim of this paper was to study the prevalence of NALFD and advanced fibrosis among T2DM patients.
Methods
This is a cross‐sectional study of consecutive adult T2DM patients attending the Diabetes Clinic of a university hospital. Significant hepatic steatosis and advanced fibrosis was diagnosed based on transient elastography if the controlled attenuation parameter was ≥ 263 dB/m, and the liver stiffness measurement was ≥ 9.6 kPa using the M probe or ≥ 9.3 kPa using the XL probe, respectively. Patients with liver stiffness measurement ≥ 8 kPa were referred to the Gastroenterology and Hepatology Clinic for further assessment, including liver biopsy.
Results
The data of 557 patients were analyzed (mean age 61.4 ± 10.8 years, male 40.6%). The prevalence of NAFLD and advanced fibrosis based on transient elastography was 72.4% and 21.0%, respectively. On multivariate analysis, independent factors associated with NAFLD were central obesity (OR 4.856, 95% confidence interval [CI] 2.749–8.577, P = 0.006), serum triglyceride (OR 1.585, 95% CI 1.056–2.381, P = 0.026), and alanine aminotransferase levels (OR 1.047, 95% CI 1.025–1.070, P < 0.001) while advanced fibrosis was associated with serum high‐density lipoprotein cholesterol (OR 0.355, 95% CI 0.126–0.997, P = 0.049), alanine aminotransferase (OR 1.023, 95% CI 1.009–1.037, P = 0.001), γ‐glutamyltransferase (OR 1.005, 95% CI 1.001–1.008, P = 0.017), and platelet levels (OR 0.995, 95% CI 0.992–0.999, P = 0.010). Seventy‐one patients underwent liver biopsy. The majority had non‐alcoholic steatohepatitis (83.1%) and ≥ F1 fibrosis (87.3%) while advanced fibrosis was seen in 36.6%.
Conclusion
The prevalence of NAFLD and advanced fibrosis based on transient elastography is high among T2DM patients.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.14577</identifier><identifier>PMID: 30551263</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Aged ; Alanine ; Alanine transaminase ; Biopsy ; CAP ; Cholesterol ; controlled attenuation parameter ; Cross-Sectional Studies ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - epidemiology ; Elasticity Imaging Techniques ; Fatty liver ; Female ; Fibroscan ; Fibrosis ; Gastroenterology ; Humans ; Liver Cirrhosis - diagnostic imaging ; Liver Cirrhosis - epidemiology ; Liver diseases ; liver fibrosis ; liver stiffness measurement ; LSM ; Malaysia - epidemiology ; Male ; Mass Screening - methods ; Middle Aged ; Multivariate analysis ; NAFLD ; NASH ; Non-alcoholic Fatty Liver Disease - diagnostic imaging ; Non-alcoholic Fatty Liver Disease - epidemiology ; Predictive Value of Tests ; Prevalence ; Prospective Studies ; Reproducibility of Results ; Risk Factors ; Steatosis ; T2DM</subject><ispartof>Journal of gastroenterology and hepatology, 2019-08, Vol.34 (8), p.1396-1403</ispartof><rights>2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><rights>2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><rights>2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3537-5d2cb4a6399ec2abb8be50b65b50ca6db50e3e6067d92d2e1aaafacee15d0723</citedby><cites>FETCH-LOGICAL-c3537-5d2cb4a6399ec2abb8be50b65b50ca6db50e3e6067d92d2e1aaafacee15d0723</cites><orcidid>0000-0002-9105-5837 ; 0000-0001-5824-0590</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.14577$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.14577$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30551263$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lai, Lee‐Lee</creatorcontrib><creatorcontrib>Wan Yusoff, Wan Nur Illyana</creatorcontrib><creatorcontrib>Vethakkan, Shireene Ratna</creatorcontrib><creatorcontrib>Nik Mustapha, Nik Raihan</creatorcontrib><creatorcontrib>Mahadeva, Sanjiv</creatorcontrib><creatorcontrib>Chan, Wah‐Kheong</creatorcontrib><title>Screening for non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus using transient elastography</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
The recommendation in regard to screening for non‐alcoholic fatty liver disease (NAFLD) among type 2 diabetes mellitus (T2DM) patients differs in major guidelines. The aim of this paper was to study the prevalence of NALFD and advanced fibrosis among T2DM patients.
Methods
This is a cross‐sectional study of consecutive adult T2DM patients attending the Diabetes Clinic of a university hospital. Significant hepatic steatosis and advanced fibrosis was diagnosed based on transient elastography if the controlled attenuation parameter was ≥ 263 dB/m, and the liver stiffness measurement was ≥ 9.6 kPa using the M probe or ≥ 9.3 kPa using the XL probe, respectively. Patients with liver stiffness measurement ≥ 8 kPa were referred to the Gastroenterology and Hepatology Clinic for further assessment, including liver biopsy.
Results
The data of 557 patients were analyzed (mean age 61.4 ± 10.8 years, male 40.6%). The prevalence of NAFLD and advanced fibrosis based on transient elastography was 72.4% and 21.0%, respectively. On multivariate analysis, independent factors associated with NAFLD were central obesity (OR 4.856, 95% confidence interval [CI] 2.749–8.577, P = 0.006), serum triglyceride (OR 1.585, 95% CI 1.056–2.381, P = 0.026), and alanine aminotransferase levels (OR 1.047, 95% CI 1.025–1.070, P < 0.001) while advanced fibrosis was associated with serum high‐density lipoprotein cholesterol (OR 0.355, 95% CI 0.126–0.997, P = 0.049), alanine aminotransferase (OR 1.023, 95% CI 1.009–1.037, P = 0.001), γ‐glutamyltransferase (OR 1.005, 95% CI 1.001–1.008, P = 0.017), and platelet levels (OR 0.995, 95% CI 0.992–0.999, P = 0.010). Seventy‐one patients underwent liver biopsy. The majority had non‐alcoholic steatohepatitis (83.1%) and ≥ F1 fibrosis (87.3%) while advanced fibrosis was seen in 36.6%.
Conclusion
The prevalence of NAFLD and advanced fibrosis based on transient elastography is high among T2DM patients.</description><subject>Aged</subject><subject>Alanine</subject><subject>Alanine transaminase</subject><subject>Biopsy</subject><subject>CAP</subject><subject>Cholesterol</subject><subject>controlled attenuation parameter</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Elasticity Imaging Techniques</subject><subject>Fatty liver</subject><subject>Female</subject><subject>Fibroscan</subject><subject>Fibrosis</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Liver Cirrhosis - diagnostic imaging</subject><subject>Liver Cirrhosis - epidemiology</subject><subject>Liver diseases</subject><subject>liver fibrosis</subject><subject>liver stiffness measurement</subject><subject>LSM</subject><subject>Malaysia - epidemiology</subject><subject>Male</subject><subject>Mass Screening - methods</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>NAFLD</subject><subject>NASH</subject><subject>Non-alcoholic Fatty Liver Disease - diagnostic imaging</subject><subject>Non-alcoholic Fatty Liver Disease - epidemiology</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Risk Factors</subject><subject>Steatosis</subject><subject>T2DM</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9u1DAQhy0Eokvh0BdAlnqBQ1rbiZ3Nsar6h6oSB3q3Js5k16usHWynbW48Qp-RJ8HLtj0gMZffYT59Gs2PkCPOTnie081qfcIrWddvyIJXFSt4Xam3ZMGWXBZNyZsD8iHGDWOsYrV8Tw5KJiUXqlyQxx8mIDrrVrT3gTrvfv96gsH4tR-soT2kNNPB3mOgnY0IEal1dIRk0aVIH2xa0zSPSEXeQ4sJI93iMNg0RTrFnTcFcHGHUxwgJr8KMK7nj-RdD0PET895SO4uL-7Or4vb71ffzs9uC1PKsi5kJ0xbgSqbBo2Atl22KFmrZCuZAdXlwBIVU3XXiE4gB4AeDCKXHatFeUi-7LVj8D8njElvbTT5QHDop6gFl7VSXLAqo8f_oBs_BZeP00Is2VIyJlWmvu4pE3yMAXs9BruFMGvO9K4NndvQf9vI7Odn49RusXslX96fgdM98GAHnP9v0jdX13vlH6wVlxs</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Lai, Lee‐Lee</creator><creator>Wan Yusoff, Wan Nur Illyana</creator><creator>Vethakkan, Shireene Ratna</creator><creator>Nik Mustapha, Nik Raihan</creator><creator>Mahadeva, Sanjiv</creator><creator>Chan, Wah‐Kheong</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9105-5837</orcidid><orcidid>https://orcid.org/0000-0001-5824-0590</orcidid></search><sort><creationdate>201908</creationdate><title>Screening for non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus using transient elastography</title><author>Lai, Lee‐Lee ; Wan Yusoff, Wan Nur Illyana ; Vethakkan, Shireene Ratna ; Nik Mustapha, Nik Raihan ; Mahadeva, Sanjiv ; Chan, Wah‐Kheong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3537-5d2cb4a6399ec2abb8be50b65b50ca6db50e3e6067d92d2e1aaafacee15d0723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Alanine</topic><topic>Alanine transaminase</topic><topic>Biopsy</topic><topic>CAP</topic><topic>Cholesterol</topic><topic>controlled attenuation parameter</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - diagnosis</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Elasticity Imaging Techniques</topic><topic>Fatty liver</topic><topic>Female</topic><topic>Fibroscan</topic><topic>Fibrosis</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Liver Cirrhosis - diagnostic imaging</topic><topic>Liver Cirrhosis - epidemiology</topic><topic>Liver diseases</topic><topic>liver fibrosis</topic><topic>liver stiffness measurement</topic><topic>LSM</topic><topic>Malaysia - epidemiology</topic><topic>Male</topic><topic>Mass Screening - methods</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>NAFLD</topic><topic>NASH</topic><topic>Non-alcoholic Fatty Liver Disease - diagnostic imaging</topic><topic>Non-alcoholic Fatty Liver Disease - epidemiology</topic><topic>Predictive Value of Tests</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>Risk Factors</topic><topic>Steatosis</topic><topic>T2DM</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lai, Lee‐Lee</creatorcontrib><creatorcontrib>Wan Yusoff, Wan Nur Illyana</creatorcontrib><creatorcontrib>Vethakkan, Shireene Ratna</creatorcontrib><creatorcontrib>Nik Mustapha, Nik Raihan</creatorcontrib><creatorcontrib>Mahadeva, Sanjiv</creatorcontrib><creatorcontrib>Chan, Wah‐Kheong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lai, Lee‐Lee</au><au>Wan Yusoff, Wan Nur Illyana</au><au>Vethakkan, Shireene Ratna</au><au>Nik Mustapha, Nik Raihan</au><au>Mahadeva, Sanjiv</au><au>Chan, Wah‐Kheong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Screening for non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus using transient elastography</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2019-08</date><risdate>2019</risdate><volume>34</volume><issue>8</issue><spage>1396</spage><epage>1403</epage><pages>1396-1403</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
The recommendation in regard to screening for non‐alcoholic fatty liver disease (NAFLD) among type 2 diabetes mellitus (T2DM) patients differs in major guidelines. The aim of this paper was to study the prevalence of NALFD and advanced fibrosis among T2DM patients.
Methods
This is a cross‐sectional study of consecutive adult T2DM patients attending the Diabetes Clinic of a university hospital. Significant hepatic steatosis and advanced fibrosis was diagnosed based on transient elastography if the controlled attenuation parameter was ≥ 263 dB/m, and the liver stiffness measurement was ≥ 9.6 kPa using the M probe or ≥ 9.3 kPa using the XL probe, respectively. Patients with liver stiffness measurement ≥ 8 kPa were referred to the Gastroenterology and Hepatology Clinic for further assessment, including liver biopsy.
Results
The data of 557 patients were analyzed (mean age 61.4 ± 10.8 years, male 40.6%). The prevalence of NAFLD and advanced fibrosis based on transient elastography was 72.4% and 21.0%, respectively. On multivariate analysis, independent factors associated with NAFLD were central obesity (OR 4.856, 95% confidence interval [CI] 2.749–8.577, P = 0.006), serum triglyceride (OR 1.585, 95% CI 1.056–2.381, P = 0.026), and alanine aminotransferase levels (OR 1.047, 95% CI 1.025–1.070, P < 0.001) while advanced fibrosis was associated with serum high‐density lipoprotein cholesterol (OR 0.355, 95% CI 0.126–0.997, P = 0.049), alanine aminotransferase (OR 1.023, 95% CI 1.009–1.037, P = 0.001), γ‐glutamyltransferase (OR 1.005, 95% CI 1.001–1.008, P = 0.017), and platelet levels (OR 0.995, 95% CI 0.992–0.999, P = 0.010). Seventy‐one patients underwent liver biopsy. The majority had non‐alcoholic steatohepatitis (83.1%) and ≥ F1 fibrosis (87.3%) while advanced fibrosis was seen in 36.6%.
Conclusion
The prevalence of NAFLD and advanced fibrosis based on transient elastography is high among T2DM patients.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30551263</pmid><doi>10.1111/jgh.14577</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9105-5837</orcidid><orcidid>https://orcid.org/0000-0001-5824-0590</orcidid></addata></record> |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Aged Alanine Alanine transaminase Biopsy CAP Cholesterol controlled attenuation parameter Cross-Sectional Studies Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - epidemiology Elasticity Imaging Techniques Fatty liver Female Fibroscan Fibrosis Gastroenterology Humans Liver Cirrhosis - diagnostic imaging Liver Cirrhosis - epidemiology Liver diseases liver fibrosis liver stiffness measurement LSM Malaysia - epidemiology Male Mass Screening - methods Middle Aged Multivariate analysis NAFLD NASH Non-alcoholic Fatty Liver Disease - diagnostic imaging Non-alcoholic Fatty Liver Disease - epidemiology Predictive Value of Tests Prevalence Prospective Studies Reproducibility of Results Risk Factors Steatosis T2DM |
| title | Screening for non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus using transient elastography |
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