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在印度2型糖尿病患者中,通过瞬时弹性成像测量的非酒精性脂肪性肝病所致具有临床意义的肝纤维化患病率。

Prevalence of Clinically Significant Liver Fibrosis as Measured by Transient Elastography due to Non-alcoholic Fatty Liver Disease in Indian Individuals with Type 2 Diabetes Mellitus.

作者信息

Deb Rajat, Goswami Soumik, Sengupta Nilanjan, Baidya Arjun, Khare Vibhu R, Datta Joydip, Jhaveri Kunal, Das Mousumi, Ray Debes

机构信息

Department of Endocrinology, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.

Department of Medical Affairs, Zydus Lifesciences Limited, Mumbai, Maharashtra, India.

出版信息

Indian J Endocrinol Metab. 2024 Jul-Aug;28(4):385-390. doi: 10.4103/ijem.ijem_203_23. Epub 2024 Jun 6.

Abstract

INTRODUCTION

There is high prevalence of non-alcoholic fatty liver disease in individuals with type 2 diabetes mellitus (T2D), and available evidence suggests higher prevalence of NASH and advanced stages of fibrosis among T2D. Data regarding prevalence of clinically significant liver fibrosis (CSLF) in individuals with T2D is scarce. We investigated the prevalence of transient elastography (TE)-proven CSLF among patients of T2D attending a diabetes clinic at a tertiary care center.

METHODS

A cross-sectional descriptive evaluation study of 603 consecutive adults with T2D was conducted to detect CSLF using TE. Steatosis was diagnosed using a controlled attenuation parameter >237 dB/m.

RESULTS

The prevalence of CSLF was 22.7%, and the prevalence of steatosis was 58.9% in our study. A higher body mass index (BMI) ( = 0.001), aspartate aminotransferase (AST; = 0.0001), alanine aminotransferase (ALT; = 0.0001), and low platelets ( = 0.0001) were independent factors associated with CSLF. Elevated ALT and AST (≥40 units/L) levels were present in only 27.7% and 37.2% of individuals with CSLF, respectively. Twenty-six (4.31%) individuals had LSM > 13.0 kPa.

CONCLUSION

CSLF is highly prevalent in T2D patients attending a diabetes clinic at a tertiary care center, and the majority of such individuals have normal transaminase levels. Higher BMI, AST, and ALT values and lower platelet counts are associated with liver fibrosis.

摘要

引言

2型糖尿病(T2D)患者中非酒精性脂肪性肝病的患病率很高,现有证据表明T2D患者中NASH和肝纤维化晚期的患病率更高。关于T2D患者中具有临床意义的肝纤维化(CSLF)患病率的数据很少。我们调查了在一家三级医疗中心糖尿病诊所就诊的T2D患者中经瞬时弹性成像(TE)证实的CSLF的患病率。

方法

对603例连续性成年T2D患者进行横断面描述性评估研究,以使用TE检测CSLF。使用受控衰减参数>237 dB/m诊断脂肪变性。

结果

在我们的研究中,CSLF的患病率为22.7%,脂肪变性的患病率为58.9%。较高的体重指数(BMI)(P = 0.001)、天冬氨酸转氨酶(AST;P = 0.0001)、丙氨酸转氨酶(ALT;P = 0.0001)和低血小板计数(P = 0.0001)是与CSLF相关的独立因素。仅分别有27.7%和37.2%的CSLF患者ALT和AST水平升高(≥40单位/L)。26例(4.31%)患者的肝脏硬度值(LSM)>13.0 kPa。

结论

在三级医疗中心糖尿病诊所就诊的T2D患者中,CSLF非常普遍,且大多数此类患者转氨酶水平正常。较高的BMI、AST和ALT值以及较低的血小板计数与肝纤维化有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bb2/11451953/514cf15d7b26/IJEM-28-385-g001.jpg

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