Histopathological differences in patients with biopsy-proven non-alcoholic fatty liver disease with and without type 2 diabetes

Fuente, Rocío Aller de la; Cuadrado, Natalia Mora; Sánchez, Carla Tafur; Gómez, Juan José López; Cuesta, Sara Gómez de la; Sánchez, M. C.; Melero, Beatriz Antolín; Román, Daniel Antonio de Luis

doi:10.1016/j.endinu.2017.12.011

Cited by 12 publications

(11 citation statements)

References 30 publications

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“…A metanalysis by Lonardo et al, which consisted of 28 longitudinal studies, showed that the prevalence rate of NAFLD in diabetic populations varied from 50% to 78%, according to ethnicity [ 31 ]. Rocío Aller de la Fuente et al found in a study that analyzed 217 liver biopsies from a Western population with known T2DM that 80.6% had steatosis [ 32 ]. There is a high variation in research regarding the prevalence of NAFLD in diabetic populations depending on the diagnostic test that was used [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis

et al. 2021

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Background: Emerging evidence suggests that patients with metabolic (dysfunction) associated fatty liver disease (MAFLD) are prone to severe forms of coronavirus disease (COVID-19), especially those with underlying liver fibrosis. The aim of our study is to assess the association of an increased FIB-4 score with COVID-19 disease prognosis. Methods: We performed a prospective study on hospitalized patients with known type II diabetes mellitus (T2DM) and confirmed COVID-19, with imaging evidence of liver steatosis within the last year or known diagnosis of MAFLD. All individuals were screened for liver fibrosis with a FIB-4 index. We evaluated the link between FIB-4 and disease prognosis. Results: Of 138 participants, 91.3% had MAFLD and 21.5% patients had a high risk of fibrosis. In the latter group of patients, the number of severe forms of disease, the hospital stay length, the rate of ICU admissions and the number of deaths reported registered a statistically significant increase. The independent predictors for developing severe forms of COVID-19 were obesity (odds ratio (OR), 3.24; 95% confidence interval (CI), p = 0.003), higher values of ferritin (OR-1.9; 95% CI, 1.17–8.29, p = 0.031) and of FIB-4 ≥ 3.25 (OR-4.89; 95% CI, 1.34–12.3, p = 0.02). Conclusions: Patients with high scores of FIB-4 have poor clinical outcomes and liver fibrosis may have a relevant prognostic role. Although the link between liver fibrosis and the prognosis of COVD-19 needs to be evaluated in further studies, screening for liver fibrosis with FIB-4 index, particularly in patients at risk, such as those with T2DM, will make a huge contribution to patient risk stratification.

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Section: Discussionmentioning

confidence: 99%

The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis

et al. 2021

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“…Методом логистической регрессии доказана связь между СД и НАСГ, а также показана роль СД как независимого фактора риска тяжелого ФП. Результаты нашего исследования частично согласуются с приведенными результатами: в нашей работе пациенты с СД также имели более высокие показатели ФП, чем больные без диабета [23].…”

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Non-alcoholic fatty liver disease and type 2 diabetes mellitus: issues of the liver fibrosis diagnostics

Anisonyan

Sandler

Кhaimenova

et al. 2020

Terapevticheskii arkhiv

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Aim. To evaluate the frequency of liver fibrosis progression to stage 34 among patients with non-alcoholic fatty liver disease (NAFLD), type 2 diabetes and obesity, to identify predictors of severe liver fibrosis, to propose an algorithm for diagnosing fibrosis in this category of patients. Materials and methods. 160 patients with NAFLD, type 2 diabetes mellitus (DM) and obesity and 50 patients with NAFLD without diabetes were comprehensively examined. Patients underwent laboratory examination (clinical blood test, biochemical analysis, immunoglobulins G, M, autoantibody assay, coagulogram), liver ultrasound. All patients underwent determination of the liver fibrosis stage by two methods: the serological test FibroMax and indirect ultrasound elastometry of the liver; 40 patients underwent a liver biopsy. Statistical data processing was performed using the programming language and statistical calculations R: we used correlation analysis, multiple logistic regression method, one-way analysis of variance, multi-factor analysis, the Kruskal-Wallis method, and comparison of the number of patients using the Fisher test. Results. DM is a risk factor for the liver fibrosis progression in patients with NAFLD. Significant markers of severe fibrosis in this category of patients are increased levels of GGTP, haptoglobin and alpha-2-macroglobulin, lower platelet and prothrombin levels. Obesity and isolated steatosis without steatohepatitis are not markers of severe liver fibrosis at present, but obesity can be considered a risk factor for the progression of fibrosis in the future. Conclusion. All patients with NAFLD in combination with diabetes need screening to detect advanced liver fibrosis: it is advisable to determine the levels of GGTP, haptoglobin and alpha-2-macroglobulin.

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“…The reported incidence of NASH among NAFLD has been variable (2–20%) because of differences in diagnosis methods and patients cohorts 2,28. In general, the incidence of NASH becomes higher as steatosis levels increase and is highly associated with the presence of diabetes mellitus 4,29,30. We compared background and clinical factors between groups separated by a CAP threshold of 264 dB/m, which allowed significant differentiation of IR in our study population.…”

Section: Discussionmentioning

confidence: 99%

Practical Use of Transient Elastography in Screening for Nonalcoholic Steatohepatitis in a Japanese Population

Hirono

Watanabe

Hasegawa

et al. 2019

Journal of Clinical and Translational Hepatology

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Background and Aims: Fatty infiltration of liver may induce insulin resistance (IR), and a proportion of patients with nonalcoholic fatty liver disease (NAFLD) is diagnosed with nonalcoholic steatohepatitis. Transient elastography is gaining popularity as a means of non-invasively determining both liver stiffness (fibrosis level) and degree of fatty infiltration, expressed as controlled attenuation parameter (CAP) value. Methods: The aims of this study were to investigate the association between IR and level of fatty liver, and to identify the group at a greater risk of nonalcoholic steatohepatitis using transient elastography and other noninvasive fibrosis markers. A total of 169 patients without chronic hepatitis B and C were analyzed. Results: The CAP value was significantly associated with IR (HOMA-IR ≥2.5; AUROC = 0.81), and the optimal cut-off to discriminate IR was 264 dB/m. The liver stiffness measurement and aspartate aminotransferase-to-platelet ratio index values were significantly higher for CAP ≥264 than in CAP <264. The 9 patients among the overall 169 patients (5.3%) and among the 102 NAFLD patients (8.8%) who showed ≥264 dB and ≥7.0 kPa in transient elastography could represent good candidates for liver biopsy. Conclusions: Evaluation of NAFLD based on CAP values was useful in diagnosing IR. About 9% of NAFLD patients in a Japanese outpatient clinic with a few metabolic complications might be considered good candidates for liver biopsy to confirm nonalcoholic steatohepatitis.

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Histopathological differences in patients with biopsy-proven non-alcoholic fatty liver disease with and without type 2 diabetes

Cited by 12 publications

References 30 publications

The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis

The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis

Non-alcoholic fatty liver disease and type 2 diabetes mellitus: issues of the liver fibrosis diagnostics

Practical Use of Transient Elastography in Screening for Nonalcoholic Steatohepatitis in a Japanese Population

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