Abstract
Background: Metabolic dysfunction associated fatty liver disease (MAFLD) is a common finding in people with type 2 diabetes (T2D). Aims: To evaluate the association of liver steatosis and fibrosis in Asian-Indians with T2D using Vibration-Controlled Transient Elastography (VCTE). Methods: A total of 120 patients underwent NAFLD screening from July 2022 to December 2022 after excluding alcoholics and nondiabetes patients we had 73 people with T2D, recruited from Liver Clinic of Endocrine speciality centre. VCTE (Fibroscan 430 Mini Plus, Echosens, France) was used for Liver Stiffness measurement (LSM) in KiloPascals (KPa) and Controlled Attenuation Parameter (CAP) in Decibels per meter (dB/m). CAP score cut-offs used for steatosis: Grade 0 < 237 dB/m, Grade I is 238 - 259 dB/m Grade II is 260 - 292 dB/m and Grade III > 292 dB/m. LSM cut-off values used: F0 < 7 kPa, F1 is 7 - 10 kPa, F2 is 10 - 13 kPa, F3 is 13 - 16 kPa and F4 > 16 kPa. Results: The mean age was 53.4 ± 12.5 years and 26% (n=19) were women. Overweight seen in 21.9 % (n=16) and obesity in 67.1 % (n=49). We found liver steatosis in 73.7% (n=56) having Grade I in 16.4 % (n=12), Grade II in 34.2 % (n=25) and Grade III in 26 % (n=19). Liver fibrosis was detected in 30.1 % (n=22) with Mild fibrosis (F1) in 20.5 % (n=15) and clinically significant in 9.5 % (n=7) i.e., Moderate fibrosis (F2) in 6.8 % (n=5) and Cirrhosis grade (F4) in 2.7 % (n=2). We noticed that CAP score had significant positive correlation with BMI (P=0.01) and LSM had significant positive correlation with BMI (p=0.001), SGOT (p=0.01), SGPT (p=0.015) and Platelet count (P=0.04). Conclusions: Our data demonstrated that people with T2D have a high prevalence of steatosis and fibrosis which can lead to the development and progression of complications with high morbidity and mortality rates. So, we suggest screening for MAFLD should be a universal approach in diabetes co-morbidities management. Disclosure S. Chandel: None.K. Ravi Teja: None.
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