Abstract
Aims To investigate morbidity and mortality in a real-life cohort of patients with type 2 diabetes (T2D) in relation to prevalence and severity of nonalcoholic fatty liver disease (NAFLD). Methods Patients with T2D were referred for assessment of liver fibrosis by the FIB-4 test and liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE). Liver steatosis was quantified by the controlled attenuation parameter (CAP). These patients were followed until death or censored date. Results Among 454 patients (52% males, mean age 62.5 years, BMI 30.9 kg/m2), 82.6% was overweight, 77.8% had fatty liver, and 9.9% and 3.1% had LSM and FIB-4 values suggestive of advanced fibrosis, respectively. During the follow-up period of median 2 years, 106 (23%) patients experienced adverse event (11% cardiovascular) and 17 (3.7%) died, whereas no liver-related morbidity or mortality was observed. Independent predictors of adverse outcomes were age and higher platelet count, while FIB-4, LSM, and CAP were not. Conclusion In a cohort of T2D patients, no liver-related morbidity or mortality occurred during 2 years. Our patients probably have low real prevalence of advanced fibrosis which is likely overestimated by LSM ≥ 9.6 kPa. Liver fibrosis may be safely reassessed in the 2 years interval in noncirrhotic patients with T2D.
Highlights
Type 2 diabetes (T2D) is among the most prevalent conditions today, affecting almost 10% of the adult population worldwide [1]
Liver stiffness measurement (LSM) as the surrogate for liver fibrosis and controlled attenuation parameter (CAP) for liver steatosis was assessed by vibration-controlled transient elastography (VCTE) with the FibroScan Touch 502 machine by 3 experienced operators (IG, SM, and TB, each having performed > 500 examinations) in fasting patients
We evaluated a total of 468 patients; in 14/468 (2.99%), VCTE measurements were unsuccessful, so a total of 454 patients with T2D (236; 52% males) with mean age (SD) of 62.5 (12) years were recruited
Summary
Ivica Grgurevic ,1 Nermin Salkic, Sanda Mustapic ,1 Tomislav Bokun, Kristian Podrug, Srecko Marusic, Dario Rahelic, Tomas Matic, Viktoria Skurla, and Ivana Mikolasevic 8. To investigate morbidity and mortality in a real-life cohort of patients with type 2 diabetes (T2D) in relation to prevalence and severity of nonalcoholic fatty liver disease (NAFLD). Among 454 patients (52% males, mean age 62.5 years, BMI 30.9 kg/m2), 82.6% was overweight, 77.8% had fatty liver, and 9.9% and 3.1% had LSM and FIB-4 values suggestive of advanced fibrosis, respectively. During the follow-up period of median 2 years, 106 (23%) patients experienced adverse event (11% cardiovascular) and 17 (3.7%) died, whereas no liver-related morbidity or mortality was observed. In a cohort of T2D patients, no liver-related morbidity or mortality occurred during 2 years. Our patients probably have low real prevalence of advanced fibrosis which is likely overestimated by LSM ≥ 9.6 kPa. Liver fibrosis may be safely reassessed in the 2 years interval in noncirrhotic patients with T2D
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