Prognostic value of liver fibrosis and steatosis biomarkers in type‐2 diabetes and dyslipidaemia. Issue 9 (3rd September 2014)

• Record Type: Journal Article
• Authors: Perazzo, H.; Munteanu, M.; Ngo, Y.; Lebray, P.; Seurat, N.; Rutka, F.; Couteau, M.; Jacqueminet, S.; Giral, P.; Monneret, D.; Imbert‐Bismut, F.; Ratziu, V.; Hartemann‐Huertier, A.; Housset, C.; Poynard, T.; the FLIP Consortium
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 40:Issue 9(2014)
• Page Start: 1081
• Page End: 1093
• Publication Date: 2014-09-03
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12946
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt12946-abs-0001"> <title>Summary</title> <sec id="apt12946-sec-0001" sec-type="section"> <title>Background</title> <p>In cardiometabolic disorders, non‐alcoholic fatty liver disease is frequent and presumably associated with increased mortality and cardiovascular risk.</p> </sec> <sec id="apt12946-sec-0002" sec-type="section"> <title>Aim</title> <p>To evaluate the prognostic value of non‐invasive biomarkers of liver fibrosis (FibroTest) and steatosis (SteatoTest) in patients with type‐2 diabetes and/or dyslipidaemia.</p> </sec> <sec id="apt12946-sec-0003" sec-type="section"> <title>Methods</title> <p>A total of 2312 patients with type‐2 diabetes and/or dyslipidaemia were included and prospectively followed up for 5–15 years. The cardiovascular Framingham‐risk score was calculated; advanced fibrosis and severe steatosis, were defined by FibroTest >0.48 and SteatoTest >0.69, respectively, as previously established.</p> </sec> <sec id="apt12946-sec-0004" sec-type="section"> <title>Results</title> <p>During a median follow‐up of 12 years, 172 patients (7.4%) died. The leading causes of mortality were cancer (31%) and cardiovascular‐related death (20%). The presence of advanced fibrosis [HR (95% CI)] [2.98 (95% CI 1.78–4.99); <italic>P </italic>< 0.0001] or severe steatosis [1.86 (1.34–2.58); <italic>P </italic>= 0.0002] was associated with an increased risk of mortality. In a multivariate Cox model adjusted for confounders: the presence of advanced fibrosis was associated with overall mortality [1.95 (1.12–3.41); <italic>P </italic>= 0.02]; advanced fibrosis at baseline [<italic>n</italic> = 50/677; 1.92 (1.04–3.55); <italic>P </italic>= 0.04] and progression to advanced fibrosis during follow‐up [<italic>n</italic> = 16/127; 4.8 (1.5–14.9); <italic>P </italic>= 0.007] were predictors of cardiovascular events in patients with type‐2 diabetes. In patients with a Framingham‐risk score ≥20%, the presence of advanced fibrosis was predictive of cardiovascular events [2.24 (1.16–4.33); <italic>P </italic>< 0.05].</p> </sec> <sec id="apt12946-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Liver biomarkers, such as FibroTest and SteatoTest, have prognostic values in patients with metabolic disorders. FibroTest has prognostic value for predicting overall survival in patients with type‐2 diabetes and/or dyslipidaemia. In type‐2 diabetes, FibroTest predicted cardiovascular events and improved the Framingham‐risk score.</p> </sec> </abstract>