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Non‐invasive hepatic biomarkers ( ELF and CK 18) in people with type 2 diabetes: the Edinburgh type 2 diabetes study
Author(s) -
Morling Joanne R.,
Fallowfield Jonathan A.,
Williamson Rachel M.,
Nee Lisa D.,
Jackson Andrew P.,
Glancy Stephen,
Reynolds Rebecca M.,
Hayes Peter C.,
Guha Indra N.,
Strachan Mark W. J.,
Price Jackie F.
Publication year - 2014
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12385
Subject(s) - medicine , type 2 diabetes , fatty liver , diabetes mellitus , cohort , risk factor , gastroenterology , prospective cohort study , chronic liver disease , cytokeratin , cohort study , liver disease , endocrinology , disease , cirrhosis , immunohistochemistry
Background & Aims Type 2 diabetes is an established risk factor for the presence and progression of fatty liver. Little is known about the distributions and correlates of hepatic non‐invasive biomarkers in community‐based populations with diabetes, unselected for liver disease. We aimed to identify the distribution of, and metabolic risk factors associated with serum cytokeratin‐18 ( CK 18) and the Enhanced Liver Fibrosis score ( ELF ), in a large, representative cohort of people with type 2 diabetes (the Edinburgh Type 2 Diabetes Study, ET 2 DS ). Methods Nine hundred and thirty‐nine ET 2 DS participants, aged 60–74 years underwent physical examination including ultrasound for assessment of liver fat. Representative subgroups were assessed for markers of chronic liver disease ( CK 18 and ELF ). Results CK 18 values ranged from 29–993 U/L (median 102, IQR 76–137 U/L) and ELF scores ranged from 6.9–11.6 (mean 8.9, SD 0.8). Statistically significant associations were found between both biomarkers and a number of metabolic risk factors. Neither CK 18 nor ELF was consistently or strongly associated with established hepatic risk factors (alcohol excess, hepatotoxic medication use and positive immunology titres). Conclusions We identified the distribution of CK 18 and ELF in a large cohort of older people with type 2 diabetes and showed that these markers are associated with an adverse metabolic risk factor profile, although much of the variation in biomarkers remained unexplained. Prospective studies are required to determine the extent to which CK 18 and/or ELF predict the development of symptomatic liver disease and to identify additional risk factors which may influence the development of advanced liver disease in people with type 2 diabetes.