Identifying advanced MAFLD in a cohort of T2DM and clinical features
BackgroundMAFLD is the most common cause of chronic liver disease, affecting 25% of the global population. Patients with T2DM have an increased risk of developing MAFLD. In addition, patients with T2DM have a higher risk of advanced forms of steatohepatitis and fibrosis. Identifying those patients i...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1058995/full |
| _version_ | 1797900425801760768 |
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| author | Ana Maria Sanchez-Bao Alfonso Soto-Gonzalez Manuel Delgado-Blanco Vanesa Balboa-Barreiro Diego Bellido |
| author_facet | Ana Maria Sanchez-Bao Alfonso Soto-Gonzalez Manuel Delgado-Blanco Vanesa Balboa-Barreiro Diego Bellido |
| author_sort | Ana Maria Sanchez-Bao |
| collection | DOAJ |
| description | BackgroundMAFLD is the most common cause of chronic liver disease, affecting 25% of the global population. Patients with T2DM have an increased risk of developing MAFLD. In addition, patients with T2DM have a higher risk of advanced forms of steatohepatitis and fibrosis. Identifying those patients is critical in order to refer them to specialist and appropriate management of their disease.Aims and ObjectivesTo estimate advanced fibrosis prevalence in a cohort of patients with T2DM and to identify possible predictors.Methodssubjects with T2DM during regular health check-up were enrolled. Demographic and general characteristics were measured, including metabolic parameters and homeostasis model assessment of insulin resistance (HOMA2-IR). Four non-invasive fibrosis scores (NAFLD fibrosis scores, FIB-4, APRI, Hepamet fibrosis score) were measure and compared with transient elastography (TE).Results96 patients (21%) presented risk of significant fibrosis (≥F2) measured by TE and 45 patients (10%) presented with risk of advanced fibrosis F3-F4. Liver fibrosis was related to BMI, AC, HOMA2-IR. The results of the non-invasive fibrosis scores have been validated with the results obtained in the TE. It is observed that the index with the greatest area under the curve (AUC) is APRI (AUC=0.729), with a sensitivity of 62.2% and a specificity of 76.1%. However, the test with better positive likelihood ratio (LR+) in our study is NAFLD fibrosis score.ConclusionsOur results show that in a general T2DM follow up, 10% of patients were at risk of advanced fibrosis. We found a positive correlation between liver fibrosis and BMI, AC and HOMA2-IR. Non-invasive fibrosis markers can be useful for screening, showing NAFLD Fibrosis score a better LHR+ compared to TE. Further studies are needed to validate these results and elucidate the best screening approach to identify those patients at risk of advanced MAFLD. |
| first_indexed | 2024-04-10T08:44:43Z |
| format | Article |
| id | doaj.art-65dfb0613d174e75b9267b8e406a5c91 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-10T08:44:43Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-65dfb0613d174e75b9267b8e406a5c912023-02-22T09:22:01ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-02-011410.3389/fendo.2023.10589951058995Identifying advanced MAFLD in a cohort of T2DM and clinical featuresAna Maria Sanchez-Bao0Alfonso Soto-Gonzalez1Manuel Delgado-Blanco2Vanesa Balboa-Barreiro3Diego Bellido4Division of Endocrinology and Nutrition, Ferrol University Clinical Hospital, Ferrol, SpainDivision of Endocrinology and Nutrition, A Coruña University Clinical Hospital, A Coruña, SpainDivision of Gastroenterology and Hepatology, A Coruña University Clinical Hospital, A Coruña, SpainEpidemiology Department, A Coruña University Clinical Hospital, A Coruña, SpainDivision of Endocrinology and Nutrition, Ferrol University Clinical Hospital, Ferrol, SpainBackgroundMAFLD is the most common cause of chronic liver disease, affecting 25% of the global population. Patients with T2DM have an increased risk of developing MAFLD. In addition, patients with T2DM have a higher risk of advanced forms of steatohepatitis and fibrosis. Identifying those patients is critical in order to refer them to specialist and appropriate management of their disease.Aims and ObjectivesTo estimate advanced fibrosis prevalence in a cohort of patients with T2DM and to identify possible predictors.Methodssubjects with T2DM during regular health check-up were enrolled. Demographic and general characteristics were measured, including metabolic parameters and homeostasis model assessment of insulin resistance (HOMA2-IR). Four non-invasive fibrosis scores (NAFLD fibrosis scores, FIB-4, APRI, Hepamet fibrosis score) were measure and compared with transient elastography (TE).Results96 patients (21%) presented risk of significant fibrosis (≥F2) measured by TE and 45 patients (10%) presented with risk of advanced fibrosis F3-F4. Liver fibrosis was related to BMI, AC, HOMA2-IR. The results of the non-invasive fibrosis scores have been validated with the results obtained in the TE. It is observed that the index with the greatest area under the curve (AUC) is APRI (AUC=0.729), with a sensitivity of 62.2% and a specificity of 76.1%. However, the test with better positive likelihood ratio (LR+) in our study is NAFLD fibrosis score.ConclusionsOur results show that in a general T2DM follow up, 10% of patients were at risk of advanced fibrosis. We found a positive correlation between liver fibrosis and BMI, AC and HOMA2-IR. Non-invasive fibrosis markers can be useful for screening, showing NAFLD Fibrosis score a better LHR+ compared to TE. Further studies are needed to validate these results and elucidate the best screening approach to identify those patients at risk of advanced MAFLD.https://www.frontiersin.org/articles/10.3389/fendo.2023.1058995/fullMAFLDNAFLDNASHT2DMliver fibrosisobesity |
| spellingShingle | Ana Maria Sanchez-Bao Alfonso Soto-Gonzalez Manuel Delgado-Blanco Vanesa Balboa-Barreiro Diego Bellido Identifying advanced MAFLD in a cohort of T2DM and clinical features Frontiers in Endocrinology MAFLD NAFLD NASH T2DM liver fibrosis obesity |
| title | Identifying advanced MAFLD in a cohort of T2DM and clinical features |
| title_full | Identifying advanced MAFLD in a cohort of T2DM and clinical features |
| title_fullStr | Identifying advanced MAFLD in a cohort of T2DM and clinical features |
| title_full_unstemmed | Identifying advanced MAFLD in a cohort of T2DM and clinical features |
| title_short | Identifying advanced MAFLD in a cohort of T2DM and clinical features |
| title_sort | identifying advanced mafld in a cohort of t2dm and clinical features |
| topic | MAFLD NAFLD NASH T2DM liver fibrosis obesity |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1058995/full |
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