Alhabahbeh Ruba H, Obeidat Ala'eddien N, Jaber Dunia S, AlKhaldi Mohammed M, Ghanem Leen K, Tubasi Ahmad A, Obeidat Zaina N, Alhawari Hussam H
Department of Family Medicine and Public Health, School of Medicine, University of Jordan, Amman, Jordan.
Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan.
Int J Endocrinol. 2025 Aug 21;2025:6676114. doi: 10.1155/ije/6676114. eCollection 2025.
To screen for the prevalence and severity of nonalcoholic fatty liver disease (NAFLD) and degree of liver fibrosis in patients with prediabetes and Type 2 diabetes. Additionally, we sought to compare the results obtained from different screening systems. We screened 254 patients for NAFLD using three systems: Fatty Liver Index (FLI), Fibrosis 4 (FIB-4) Index, and NAFLD Fibrosis Score (NFS). About two-thirds were females (63%). The mean age was 59.15 ± 10.09 years, and mean BMI was 34.14 ± 6.60 kg/m. Among participants, 85.5% had Type 2 diabetes and 14.5% had prediabetes. Additionally, 81.1% were on metformin, and 39.6% were on insulin. Probable steatosis (NAFLD) prevalence was 77.0% (FLI score) in our cohort. Moderate to advanced liver fibrosis was 12.6% (NFS score) and 20.7% (FIB-4 score). Significant discrepancies were noted: FIB-4 identified 21.6% of patients with moderate to severe fibrosis, which FLI did not recognize as NAFLD. FIB-4 also identified 26 patients with moderate to severe fibrosis that NFS missed. The FIB-4 and FLI score discrepancy was more common in females (10.2% vs. 1.7%, = 0.046) and in patients with diabetes compared to prediabetes (21.7% vs. 4.5%, = 0.003). The FIB-4 and NFS score discrepancy was more common in patients with higher BMI (38.38 ± 7.78 vs. 33.59 ± 6.82, < 0.001) and in those with prediabetes compared to diabetes (34.8% vs. 12.8%, = 0.008). The study found a high prevalence (77%) of NAFLD in individuals with prediabetes and diabetes. About 20% had moderate to advanced liver fibrosis. NAFLD prevalence and severity varied significantly across three scoring systems. Key factors for refining screening strategies include patient sex, BMI, and the level of insulin resistance.
筛查糖尿病前期和2型糖尿病患者中非酒精性脂肪性肝病（NAFLD）的患病率和严重程度以及肝纤维化程度。此外，我们试图比较不同筛查系统所得的结果。我们使用三种系统对254例患者进行NAFLD筛查：脂肪肝指数（FLI）、纤维化4（FIB-4）指数和NAFLD纤维化评分（NFS）。约三分之二为女性（63%）。平均年龄为59.15±10.09岁，平均体重指数为34.14±6.60kg/m²。参与者中，85.5%患有2型糖尿病，14.5%患有糖尿病前期。此外，81.1%的患者正在服用二甲双胍，39.6%的患者正在使用胰岛素。在我们的队列中，可能的脂肪变性（NAFLD）患病率为77.0%（FLI评分）。中度至重度肝纤维化分别为12.6%（NFS评分）和20.7%（FIB-4评分）。发现存在显著差异：FIB-4识别出21.6%中度至重度纤维化患者，而FLI未将其识别为NAFLD。FIB-4还识别出26例中度至重度纤维化患者，而NFS未识别出。FIB-4与FLI评分的差异在女性中更常见（10.2%对1.7%，P = 0.046），在糖尿病患者中比糖尿病前期患者更常见（21.7%对4.5%，P = 0.003）。FIB-4与NFS评分的差异在体重指数较高的患者中更常见（38.38±7.78对33.59±6.82，P < 0.001），在糖尿病前期患者中比糖尿病患者更常见（34.8%对12.8%，P = 0.008）。该研究发现糖尿病前期和糖尿病患者中NAFLD的患病率很高（77%）。约20%的患者有中度至重度肝纤维化。NAFLD的患病率和严重程度在三种评分系统中差异显著。完善筛查策略的关键因素包括患者性别、体重指数和胰岛素抵抗水平。
