Kelkar Rohan, Phadke Uday, Kelkar Raveena, Khanapurkar Shalmi, Barve Nishad A
Internal Medicine, Sahyadri Super Speciality Hospital, Deccan Gymkhana, Pune, IND.
Endocrinology, Diabetes and Metabolism, Sahyadri Super Speciality Hospital, Deccan Gymkhana, Pune, IND.
Cureus. 2024 Aug 16;16(8):e67015. doi: 10.7759/cureus.67015. eCollection 2024 Aug.
Background Nonalcoholic fatty liver disease (NAFLD) is increasingly recognized as a cause of chronic liver disease. It can lead to complications such as decompensated liver cirrhosis and hepatocellular carcinoma. Objectives This study aimed to assess liver stiffness using point shear wave elastography in patients with diabetes and NAFLD and to compare the results with the FIB-4 (fibrosis-4) score, AST/ALT (aspartate aminotransferase-to-alanine aminotransferase) ratio, and APRI (AST-to-Platelet Ratio Index). Materials and methods A cross-sectional study was conducted on type 2 diabetes patients who underwent point shear wave liver elastography for liver stiffness estimation between January 2020 and February 2023. Demographic data such as age, sex, and laboratory data (AST, ALT, and platelet count) were recorded. FIB-4 score, APRI, and AST/ALT ratio were calculated for these patients. The results of the FIB-4 score and APRI were then compared with the shear wave liver elastography fibrosis scores. Results The analysis included 60 patients, of whom 50 (83.33%) were male, with a mean age of 44.8 years (SD: 11.02; range: 21-69). Thirty-six patients (60%) had significant fibrosis. There was a significant positive correlation between the shear wave elastography results and the FIB-4 and APRI scores. Conclusion The findings revealed that nearly two-thirds of the study group had significant fibrosis (≥F2), highlighting the need for early NAFLD diagnosis and treatment. Noninvasive laboratory serum markers, in conjunction with shear wave liver elastography, are useful for diagnosing severe fibrosis.
背景 非酒精性脂肪性肝病（NAFLD）日益被认为是慢性肝病的一个病因。它可导致诸如失代偿期肝硬化和肝细胞癌等并发症。目的 本研究旨在使用点剪切波弹性成像评估糖尿病合并NAFLD患者的肝脏硬度，并将结果与FIB-4（纤维化-4）评分、AST/ALT（天冬氨酸氨基转移酶与丙氨酸氨基转移酶）比值以及APRI（AST与血小板比值指数）进行比较。材料与方法 对2020年1月至2023年2月期间接受点剪切波肝脏弹性成像以评估肝脏硬度的2型糖尿病患者进行了一项横断面研究。记录了年龄、性别等人口统计学数据以及实验室数据（AST、ALT和血小板计数）。为这些患者计算了FIB-4评分、APRI和AST/ALT比值。然后将FIB-4评分和APRI的结果与剪切波肝脏弹性成像纤维化评分进行比较。结果 分析纳入了60例患者，其中50例（83.33%）为男性，平均年龄44.8岁（标准差：11.02；范围：21 - 69岁）。36例患者（60%）有显著纤维化。剪切波弹性成像结果与FIB-4和APRI评分之间存在显著正相关。结论 研究结果显示，近三分之二的研究组患者有显著纤维化（≥F2），突出了早期NAFLD诊断和治疗的必要性。无创实验室血清标志物与剪切波肝脏弹性成像相结合，有助于诊断严重纤维化。
