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Identifying advanced MAFLD in a cohort of T2DM and clinical features
BACKGROUND: MAFLD 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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992874/ https://www.ncbi.nlm.nih.gov/pubmed/36909342 http://dx.doi.org/10.3389/fendo.2023.1058995 |
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author | Sanchez-Bao, Ana Maria Soto-Gonzalez, Alfonso Delgado-Blanco, Manuel Balboa-Barreiro, Vanesa Bellido, Diego |
author_facet | Sanchez-Bao, Ana Maria Soto-Gonzalez, Alfonso Delgado-Blanco, Manuel Balboa-Barreiro, Vanesa Bellido, Diego |
author_sort | Sanchez-Bao, Ana Maria |
collection | PubMed |
description | BACKGROUND: MAFLD 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 OBJECTIVES: To estimate advanced fibrosis prevalence in a cohort of patients with T2DM and to identify possible predictors. METHODS: subjects 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). RESULTS: 96 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. CONCLUSIONS: Our 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. |
format | Online Article Text |
id | pubmed-9992874 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-99928742023-03-09 Identifying advanced MAFLD in a cohort of T2DM and clinical features Sanchez-Bao, Ana Maria Soto-Gonzalez, Alfonso Delgado-Blanco, Manuel Balboa-Barreiro, Vanesa Bellido, Diego Front Endocrinol (Lausanne) Endocrinology BACKGROUND: MAFLD 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 OBJECTIVES: To estimate advanced fibrosis prevalence in a cohort of patients with T2DM and to identify possible predictors. METHODS: subjects 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). RESULTS: 96 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. CONCLUSIONS: Our 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. Frontiers Media S.A. 2023-02-22 /pmc/articles/PMC9992874/ /pubmed/36909342 http://dx.doi.org/10.3389/fendo.2023.1058995 Text en Copyright © 2023 Sanchez-Bao, Soto-Gonzalez, Delgado-Blanco, Balboa-Barreiro and Bellido https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Sanchez-Bao, Ana Maria Soto-Gonzalez, Alfonso Delgado-Blanco, Manuel Balboa-Barreiro, Vanesa Bellido, Diego Identifying advanced MAFLD in a cohort of T2DM and clinical features |
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 | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992874/ https://www.ncbi.nlm.nih.gov/pubmed/36909342 http://dx.doi.org/10.3389/fendo.2023.1058995 |
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