Concomitant screening for liver fibrosis and steatosis in French type 2 diabetic patients using Fibroscan. (2nd July 2017)

• Record Type: Journal Article
• Authors: Roulot, Dominique; Roudot‐Thoraval, Françoise; NKontchou, Gisele; Kouacou, Narcisse; Costes, Jean‐Luc; Elourimi, Ghassan; Le Clesiau, Hervé; Ziol, Marianne; Beaugrand, Michel
• Is Part Of: Liver international. Volume 37:Number 12(2017)
• Page Start: 1897
• Page End: 1906
• Publication Date: 2017-07-02
• Subjects: controlled attenuation parameter -- Fibroscan -- liver stiffness -- screening -- type 2 diabetes; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.13481
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Background: Type 2 diabetes is a risk factor for steatohepatitis and fibrosis. Non‐invasive liver stiffness (LS) and controlled attenuation parameter (CAP) measurements by Fibroscan allow assessing liver fat and fibrosis. Aim: To determine the prevalence of steatosis and significant fibrosis in a community‐based diabetic population. Methods: LS and CAP were measured in 705 patients using the standard "M probe." A second "XL probe" was used, without CAP measurement, in case of failure with the "M probe." Results: LS and CAP measurements were obtained in 437 patients (the M group), LS measurements (LSM) with the XL probe being available in additional 232 patients. After the combined use of both probes, LSM failure and unreliable result were 1.6% and 5.6% respectively. Overall, 12.7% (n=85), 7.3% and 2.1% exhibited significant or advanced fibrosis or cirrhosis (LSM≥8 kPa, ≥9.6 kPa, ≥13 kPa respectively), half of the patients with LSM≥8 kPa displayed normal liver tests. Significant and severe steatosis were measured in 75% and 24% of the M group patients. By multivariate analysis, factors associated with severe fibrosis were age, overweight, high GGT. Forty‐seven patients with LSM≥8 kPa underwent liver biopsy; 93% had steatosis and 51% severe fibrosis. A significant correlation was found between LSM values and fibrosis score with an accuracy rate of 83%, 68% and 83% for LSM≥8 kPa, ≥9.6 kPa and ≥13 kPa respectively. Conclusions: The prevalence of significant steatosis is very high and significant fibrosis affect 12.7% of the patients. Fibroscan is an effective procedure to screen for fibrosis and steatosis in diabetic patients.