Premium
Concomitant screening for liver fibrosis and steatosis in French type 2 diabetic patients using Fibroscan
Author(s) -
Roulot Dominique,
RoudotThoraval Françoise,
NKontchou Gisele,
Kouacou Narcisse,
Costes JeanLuc,
Elourimi Ghassan,
Le Clesiau Hervé,
Ziol Marianne,
Beaugrand Michel
Publication year - 2017
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.13481
Subject(s) - steatosis , medicine , gastroenterology , cirrhosis , fibrosis , transient elastography , fatty liver , liver biopsy , diabetes mellitus , steatohepatitis , population , type 2 diabetes , concomitant , overweight , liver fibrosis , biopsy , obesity , endocrinology , disease , environmental health
Background Type 2 diabetes is a risk factor for steatohepatitis and fibrosis. Non‐invasive liver stiffness ( LS ) and controlled attenuation parameter ( CAP ) measurements by Fibroscan allow assessing liver fat and fibrosis. Aim To determine the prevalence of steatosis and significant fibrosis in a community‐based diabetic population. Methods LS and CAP were measured in 705 patients using the standard “M probe.” A second “ XL probe” was used, without CAP measurement, in case of failure with the “M probe.” Results LS and CAP measurements were obtained in 437 patients (the M group), LS measurements ( LSM ) with the XL probe being available in additional 232 patients. After the combined use of both probes, LSM failure and unreliable result were 1.6% and 5.6% respectively. Overall, 12.7% (n=85), 7.3% and 2.1% exhibited significant or advanced fibrosis or cirrhosis ( LSM ≥8 kPa, ≥9.6 kPa, ≥13 kPa respectively), half of the patients with LSM ≥8 kPa displayed normal liver tests. Significant and severe steatosis were measured in 75% and 24% of the M group patients. By multivariate analysis, factors associated with severe fibrosis were age, overweight, high GGT . Forty‐seven patients with LSM ≥8 kPa underwent liver biopsy; 93% had steatosis and 51% severe fibrosis. A significant correlation was found between LSM values and fibrosis score with an accuracy rate of 83%, 68% and 83% for LSM ≥8 kPa, ≥9.6 kPa and ≥13 kPa respectively. Conclusions The prevalence of significant steatosis is very high and significant fibrosis affect 12.7% of the patients. Fibroscan is an effective procedure to screen for fibrosis and steatosis in diabetic patients.