Endocrinology, Diabetology and Metabolic Disease Department Ibn Rochd, University Hospital of Casablanca, Casablanca, Morocco.
Hepatology- Gastrology- Enterology Department, Ibn Rochd University Hospital of Casablanca, Casablanca, Morocco.
Pan Afr Med J. 2020 Nov 25;37:270. doi: 10.11604/pamj.2020.37.270.9087. eCollection 2020.
metabolic steatopathy or non-alcoholic fatty liver disease (NAFLD) is frequently associated with type 2 diabetes mellitus (T2DM) with an increased risk of progression to advanced fibrosis. The purpose of our study was to determine the interest of hepatic steatosis index (HSI) in the detection of hepatic steatosis in patients with type 2 diabetes in order to establish an appropriate screening program of this disease in our population.
cross-sectional study involving 281 type 2 diabetics hospitalized in the Department of Endocrinology in collaboration with the Hepato-gastroenterology Department at the University Hospital Ibn Rochd Casablanca between January 2018 and June 2018. Anthropometric variables studied were, biological, hepatic steatosis index (HSI) and liver ultrasound. The HSI score of> 36 predicted the presence of fatty liver. The HSI score (fatty liver index) was calculated for all patients using the following formula: 8 × (ALT / AST) + BMI + 2 (if type 2 diabetes) + 2 (if female). Statistical analysis was performed with SPSS Version 19 software. The sensitivity and the specificity of the HSI score were calculated by 2x2 contingency table. The area under the receiver operating characteristic curve (AUROC) was also analyzed.
average age of patients was 54.15 ± 13.14 years with a female predominance (76.9% of cases), and a sex ratio of 3.32. Mean duration of diabetes of 10.5 ± 8.03 years with an average glycated hemoglobin of 10.23 ± 1.96%. BMI was 29.53 ± 4.55 kg/m, the average waist circumference was 99.51 ± 10.98 cm. 39.1% of patients were hypertensive, 58% were dyslipidemic. Abnormalities in transaminases were found in 6% of patients. Prevalence of NAFLD was 45.2% based on the HSI score > 36. This prevalence is consistent with the findings made by the liver ultrasound (47.7% of cases). Hepatic steatosis was significantly correlated with dyslipidemia (P=0.006), overweight (P=0.00015), obesity (P=0.001) and hypertriglyceridemia (P=0.0003). The sensitivity of HSI was 89.55%, negative predictive value (NPV) was 90.91%, specificity was 95.24%, and positive predictive value (PPV) was 94.49%. AUROC for HSI was at 0.979 (95% CI, 0.962-0.997).
hepatic steatosis is common among our patients; it is correlated with dyslipidemia, obesity and hypertriglyceridemia.
代谢性脂肪病或非酒精性脂肪肝（NAFLD）常与 2 型糖尿病（T2DM）相关，并增加进展为晚期纤维化的风险。我们研究的目的是确定肝脂肪变性指数（HSI）在检测 2 型糖尿病患者肝脂肪变性中的作用，以便在我们的人群中建立该疾病的适当筛查计划。
这是一项 2018 年 1 月至 6 月在卡萨布兰卡 Ibn Rochd 大学医院内分泌科与肝胆病科合作进行的 281 例 2 型糖尿病患者的横断面研究。研究的人体测量变量包括生物、肝脂肪变性指数（HSI）和肝脏超声。HSI 评分>36 预测存在脂肪肝。使用以下公式为所有患者计算 HSI 评分（脂肪肝指数）：8×（ALT/AST）+BMI+2（如果为 2 型糖尿病）+2（如果为女性）。使用 SPSS 版本 19 软件进行统计分析。通过 2x2 列联表计算 HSI 评分的灵敏度和特异性。还分析了接收器工作特征曲线（AUROC）下的面积。
患者的平均年龄为 54.15±13.14 岁，女性居多（76.9%的病例），性别比为 3.32。糖尿病平均病程为 10.5±8.03 年，平均糖化血红蛋白为 10.23±1.96%。BMI 为 29.53±4.55kg/m，平均腰围为 99.51±10.98cm。39.1%的患者患有高血压，58%的患者血脂异常。6%的患者转氨酶异常。根据 HSI 评分>36，NAFLD 的患病率为 45.2%。这一患病率与肝脏超声检查结果一致（47.7%的病例）。肝脂肪变性与血脂异常（P=0.006）、超重（P=0.00015）、肥胖（P=0.001）和高三酰甘油血症（P=0.0003）显著相关。HSI 的灵敏度为 89.55%，阴性预测值（NPV）为 90.91%，特异性为 95.24%，阳性预测值（PPV）为 94.49%。HSI 的 AUROC 为 0.979（95%CI，0.962-0.997）。
我们的患者中肝脂肪变性很常见；它与血脂异常、肥胖和高三酰甘油血症相关。
