Association between Metabolic Syndrome Components and Indices of Liver Steatosis and Stiffness by Transient Elastography in Patients with Type 2 Diabetes and Imaging-Confirmed Nonalcoholic Fatty Liver Disease

Abstract

Background and Aims: The index of liver steatosis, controlled attenuation parameter (CAP), is a relatively new introduction to Fibroscan, an established equipment for assessing liver fibrosis, in terms of liver stiffness measurement (LSM). The relationship between CAP and/or LSM and metabolic syndrome components in diabetic patients with nonalcoholic fatty liver disease (NAFLD) was unclear, and was addressed in this study. Methods: A total of 224 patients with type 2 diabetes and NAFLD confirmed by ultrasonography were recruited. Anthropometric and serum biochemical parameters were collected. CAP and LSM were measured using transient elastography. The association between metabolic syndrome components and values of CAP and LSM was analyzed. Results: The mean age of the patients was 57.9±10.2 years, their BMI was28.6± 5.5kg/m2, and the duration of diabetes was 16.6±8.3 years. Eighty-eight percent of the patients had hypertension, and 79.5% were on lipid-lowering drugs. The mean CAP was 309.3±57.9 dB/m, and median LSM was 7.9 (5.7, 10.4) kpa. There were significant rising trends in BMI, waist circumference, waist to hip ratio, white blood cell count, HbA1c, FPG, triglyceride, ALT, AST and LSM with escalating CAP tertiles, whereas age, HDL-c, AST/ALT ratio and plasma adiponectin decreased concomitantly (all p<0.05). There was a larger number of metabolic syndrome components clustering in the third as compared to the first tertile of CAP (p=0.027) and LSM (p=0.035). On the other hand, with an increasing number of metabolic syndrome components, the value of CAP (p=0.001) and LSM (p=0.025) increased accordingly. Conclusion: CAP and LSM measured by transient elastography had a strong correlation with the clustering of metabolic syndrome components in NAFLD, even in patients with long-standing type 2 diabetes. Disclosure Z. Huang: None. C. Lee: None. H. Fong: None. K.S. Lam: None.