Non-alcoholic Fatty Liver Disease (NAFLD) and Significant Hepatic Fibrosis Defined by Non-invasive Assessment in Patients with Type 2 Diabetes

Published on Jan 1, 2015in Asian Pacific Journal of Cancer Prevention
· DOI :10.7314/APJCP.2015.16.5.1789
Abhasnee Sobhonslidsuk16
Estimated H-index: 16
(MU: Mahidol University),
Akharawit Pulsombat1
Estimated H-index: 1
+ 1 AuthorsSupanna Petraksa4
Estimated H-index: 4
Sources
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD), the most common liver problem in diabetes, is a risk factor for liver cancer. Diabetes, high body mass index (BMI) and old age can all contribute to NAFLD progression. Transient elastography (TE) is used for non-invasive fibrosis assessment. Objectives: To identify the prevalence of NAFLD and significant hepatic fibrosis in diabetic patients and to assess associated factors. Materials and Methods: One hundred and forty-one diabetic and 60 normal subjects were screened. Fatty liver was diagnosed when increased hepatic echogenicity and vascular blunting were detected by ultrasonography. Liver stiffness measurement (LSM) representing hepatic fibrosis was assessed by TE. LSM ≥7 kPa was used to define significant hepatic fibrosis. Results: Four cases were excluded due to positive hepatitis B viral markers and failed TE. Diabetic patients had higher BMI, systolic blood pressure, waist circumference and fasting glucose levels than normal subjects. Fatty liver was diagnosed in 82 (60.7%) diabetic patients but in none of the normal group. BMI (OR: 1.31; 95%CI: 1.02-1.69; p=0.038) and alanine aminotransferase (ALT)(OR: 1.14; 95%CI: 1.05-1.23; p=0.002) were associated with NAFLD. Diabetic patients with NAFLD had higher LSM than those without [5.99 (2.4) vs 4.76 (2.7) kPa, p=0.005)]. Significant hepatic fibrosis was more common in diabetic patients than in normal subjects [22 (16.1%) vs 1 (1.7%), p=0.002]. Aspartate aminotransferase (AST)(OR: 1.24; 95%CI: 1.07-1.42; p=0.003) was associated with significant hepatic fibrosis. Conclusions: Sixty and sixteen percent of diabetic patients were found to have NAFLD and significant hepatic fibrosis. High BMI and ALT levels are the predictors of NAFLD, and elevated AST level is associated with significant hepatic fibrosis.
📖 Papers frequently viewed together
2015
10 Authors (Karel Dvorak, ..., Radan Bruha)
6 Citations
20203.23Endocrine
10 Authors (Rocío Aller, ..., D.A. de Luis)
6 Citations
References22
Newest
Background: In chronic hepatitis B (CHB), the presence of hepatic steatosis (HS) seems to be associated with known host and viral factors which may influence the long-term prognosis of chronic hepatitis B (CHB), probably leading to cirrhosis and hepatocellular carcinoma (HCC). Different from chronic hepatitis C (CHC), factors associated with HS in CHB are not clearly explored. Materials and Methods: 160 CHB patients were divided into two groups depending on the results of liver biopsy. Group I c...
16 CitationsSource
#1Krittapong Somboon (Thammasat University)H-Index: 1
#2Sith SiramolpiwatH-Index: 7
Last. Ratha-Korn VilaichoneH-Index: 17
view all 3 authors...
Background: Hepatocellular carcinoma (HCC) is one of the most common cancers in men and the third most common cancer in woman in Thailand. This retrospective study was designed to assess the prevalence, clinical manifestations, treatment outcomes and prognosis of HCC in the central region of Thailand. Materials and Methods: The authors retrospectively reviewed all HCC patients aged more than 15 years old in Thammasat university hospital (TUH) during the period from January 2007 to December 2012....
33 CitationsSource
#1Kyu Sik Jung (Yonsei University)H-Index: 19
#2Seung Up Kim (Yonsei University)H-Index: 55
Chronic liver disease represents a major public health problem, accounting for significant morbidity and mortality worldwide. As prognosis and management depend mainly on the amount and progression of liver fibrosis, accurate quantification of liver fibrosis is essential for therapeutic decision-making and follow-up of chronic liver diseases. Even though liver biopsy is the gold standard for evaluation of liver fibrosis, non-invasive methods that could substitute for invasive procedures have bee...
64 CitationsSource
#1Stephen P. Casey (Alfred Hospital)H-Index: 1
#2William Kemp (Alfred Hospital)H-Index: 21
Last. Stuart K. Roberts (Alfred Hospital)H-Index: 60
view all 6 authors...
Abstract Background. Type 2 diabetes mellitus (T2DM) is a major risk factor for the development of non-alcoholic fatty liver disease (NAFLD) and subsequently hepatic fibrosis. Transient elastography (TE) is a rapid, reproducible non-invasive test that may be appropriate as a screening tool for the presence of hepatic fibrosis. AIM: Assess the utility of TE as a screening tool for the presence of hepatic fibrosis in a T2DM population with no known liver disease. Methods. T2DM patients without kno...
23 CitationsSource
#1Jing GaoH-Index: 1
#2Li XieH-Index: 6
Last. Yong-Bing XiangH-Index: 1
view all 7 authors...
Hepatocellular carcinoma is a common disorder worldwide which ranks 5th and 7th most common cancer among men and women. In recent years, different incidence trends have been observed in various regions, but the reasons are not completely understood. However, due to the great public efforts in HCC prevention and alternation of lifestyle, the roles of some well documented risk factors played in hepatocarcinogenesis might have changed. This paper summarizes both the environmental and host related r...
107 CitationsSource
#1Ruben Hernaez (Johns Hopkins University)H-Index: 24
#2Mariana Lazo (Johns Hopkins University)H-Index: 37
Last. Jeanne M. Clark (Johns Hopkins University)H-Index: 71
view all 7 authors...
Fatty liver is the accumulation of fat (i.e., macro-vesicular steatosis) within the hepatic parenchyma. Nonalcoholic fatty liver disease (NAFLD), the presence of fat infiltration in the liver in the absence of excessive alcohol consumption and other causes of liver disease, is the most common cause of fatty liver, with a prevalence as high as 30% in many populations.1 NAFLD may lead to fibrosis,2 cirrhosis,3 liver cancer,4,5 liver failure requiring liver transplant,6 and mortality7, and it is as...
697 CitationsSource
#1Wen-Ko ChiouH-Index: 14
#2Bie-Yu HuangH-Index: 1
Last. Jen-Der LinH-Index: 2
view all 5 authors...
Background:��Thestudywastoinvestigatetherelationshipbetweendiabetesmellitus�(�DM),�specificcancers,� age, and gender. Methods: This was a retrospective study that examined the frequency of different forms of cancer among male and female patients with or without DM admitted to a single hospital in Taiwan between January 2009 and June 2010. Results: Of 101,002 study patients admitted to the hospital, 15,901 (15.74%) were diagnosed with DM and 16,748 (16.58%) with a malignancy. The frequency of DM ...
21 Citations
#1Vincent Wai-Sun Wong (CUHK: The Chinese University of Hong Kong)H-Index: 99
#1Vincent Wai-Sun Wong (CUHK: The Chinese University of Hong Kong)H-Index: 2
Last. Victor de Ledinghen (French Institute of Health and Medical Research)H-Index: 77
view all 12 authors...
Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in affluent countries. Accurate noninvasive tests for liver injury are urgently needed. The aim of this study was to evaluate the accuracy of transient elastography for the diagnosis of fibrosis and cirrhosis in patients with NAFLD and to study factors associated with discordance between transient elastography and histology. Two hundred forty-six consecutive patients from two ethnic groups had successful liver stif...
815 CitationsSource
#1Nina F. SchwenzerH-Index: 33
#2Fabian SpringerH-Index: 17
Last. Fritz SchickH-Index: 82
view all 6 authors...
Hepatic steatosis is the most prevalent liver disorder in the developed world. It is closely associated with features of metabolic syndrome, especially insulin resistance and obesity. The two most common conditions associated with fatty liver are alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Liver biopsy is considered the gold standard for the assessment of liver fat, but there is a need for less invasive diagnostic techniques. New imaging modalities are emerging, ...
539 CitationsSource
#1Kenneth Cusi (University of Texas Health Science Center at San Antonio)H-Index: 71
Purpose of reviewTo increase awareness about the close interrelationship between nonalcoholic fatty liver disease and type 2 diabetes mellitus, and of recent diagnostic and treatment advances in the field.Recent findingsThe perception of nonalcoholic fatty liver disease as an uncommon and benign con
139 CitationsSource
Cited By15
Newest
#2Guillem PeraH-Index: 51
Last. Núria AlonsoH-Index: 20
view all 15 authors...
OBJECTIVE To investigate the prevalence and risks factors associated with the presence of significant liver fibrosis in subjects with nonalcoholic fatty liver disease (NAFLD) with and without type 2 diabetes mellitus (T2D). DESIGN AND METHODS This study was part of a population-based study conducted in the Barcelona metropolitan area among subjects aged 18-75 years old. Secondary causes of steatosis were excluded. Moderate-to-advanced liver fibrosis was defined as a liver stiffness measurement (...
1 CitationsSource
#1Shoukat Ali SamejoH-Index: 1
#2Zaigham AbbasH-Index: 16
Last. Muhammad Asim (Ziauddin University)H-Index: 1
view all 3 authors...
We aimed to investigate 214 patients further with non-alcoholic fatty liver disease (NAFLD) as judged by transient elastography. A body mass index of ≥25 was seen in 172 (80%) of the patients. F2-F4 fibrosis, as depicted by elastography, was present in 114 (53.2%). A Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) of ≥2 was seen in 178 (83.2%). Alanine aminotransferase was elevated in 116 (54%) and aspartate aminotransferase in 88 (41.1%). Liver steatosis was significantly associate...
Source
#1Yingxin XianH-Index: 2
#2Jianping WengH-Index: 48
Last. Fen Xu (SYSU: Sun Yat-sen University)H-Index: 11
view all 3 authors...
ABSTRACT Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, placing an increasing burden on human health. NAFLD is a complex multifactorial disease involving genetic, metabolic, and environmental factors. It is closely associated with metabolic syndrome, obesity, and type 2 diabetes, of which insulin resistance is the main pathophysiological mechanism. Over the past few decades, investigation of the pathogenesis, diagnosis, and treatments has revealed di...
3 CitationsSource
Objective — to study the ratio of the main phylotypes of the gut microbiota (GM) in patients with non‑alcoholic fatty liver disease (NAFLD) depending on the body mass index and its correlation with the stage of hepatic steatosis.Materials and methods. The study included 140 individuals. The main group consisted of 120 patients with NAFLD, who were divided into two subgroups depending on body mass index: I — 85 (70.83 %) patients with concomitant obesity (OB) I — III degree, II — 35 (29.17 %) ove...
Source
#1Ahmed M. Mansour (Ain Shams University)H-Index: 1
#2Essam M. Bayoumy (Ain Shams University)H-Index: 1
Last. Ahmed Elmetwally Ahmed (Ain Shams University)H-Index: 2
view all 6 authors...
Non-alcoholic fatty liver disease (NAFLD) is regarded as the most common liver disease in the twenty-first century, and a condition leaving individuals at increased risk of extra-hepatic morbidity. Liver biopsy has long been regarded as the gold standard for diagnosis and prognostication of patients with NAFLD. However, due to its invasive nature and potential complications (e.g., bleeding), other methods for non-invasive laboratory and radiological assessment of hepatic steatosis and fibrosis i...
2 CitationsSource
#1Ghada M. Khafagy (Cairo University)H-Index: 2
#2Hatem Darwish (Cairo University)H-Index: 5
Last. Heba G. Elnahas (Cairo University)
view all 7 authors...
Abstract Background Non-Alcoholic Fatty Liver Disease (NAFLD) and diabetes mellitus (DM) frequently coexist. Intrahepatic fat accumulation, insulin resistance, and the released inflammatory signals may have a role in both. Aim:To assess NAFLD and degree of steatosis in diabetic patients compared to non-diabetic controls. Also, to determine NAFLD relation to the clinical and the biochemical data of the diabetic patients. Methods A case-control study was conducted in the Family Medicine Clinics an...
Source
#1Tran Thi Khanh Tuong (Pham Ngoc Thach University of Medicine)H-Index: 1
#2Dang Khoa Tran (Pham Ngoc Thach University of Medicine)H-Index: 3
Last. Dinh-Toi Chu (Hanoi National University of Education)H-Index: 27
view all 6 authors...
Patients with type 2 diabetes mellitus (T2DM) are at increased risk of non-alcoholic fatty liver disease (NAFLD) and might eventually progress to advanced fibrosis, cirrhosis and hepatocellular carcinoma (HCC). Recommendations on whether to screen for NAFLD in diabetic patients remains conflicted between major guidelines. Transient elastography using FibroScan with CAP (controlled attenuation parameter) can assess both liver steatosis and fibrosis simultaneously. This paper took a new look at th...
7 CitationsSource
AbstractPatients with type 2 diabetes mellitus (DM) have been shown to have increased liver fibrosis (LF) as determined by liver elastography. However, the data on LF incidence in patients with prediabetes are scarce. This study was undertaken to determine the incidence of LF and associated paramete
4 CitationsSource
#1Mohamed M Makhlouf (Ain Shams University)
#2Shereen A. Saleh (Ain Shams University)H-Index: 6
Last. Ehab Abd-Elghani (Ain Shams University)
view all 5 authors...
Background Elevated pentraxin-3 (PTX3) is related to liver pathologies such as infections, non-alcoholic fatty liver disease (NAFLD), and tumors. Aim of this study is to evaluate serum PTX3 levels in NAFLD and its affection by concomitant chronic hepatitis C viral infection (HCV). Seventy subjects were included and divided into 3 groups. Group I included 25 patients with NAFLD. Group II included 25 patients with NAFLD and chronic HCV. Group III included 20 controls. Chronic hepatitis C was diagn...
Source
#1Wei Yu KaoH-Index: 15
#2Chien-Wei Su (NYMU: National Yang-Ming University)H-Index: 32
Last. Jean-Dean Liu (TMU: Taipei Medical University)H-Index: 1
view all 6 authors...
2 CitationsSource