LIVER FIBROSIS AND STEATOSIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A TRANSIENT ELASTOGRAPHY STUDY

Background :The prevalence of non-alcoholic fatty liver disease is notably high among patients with type 2 diabetes mellitus (T2DM). The objective of this study was to assess the potential utility of transient elastography (TE), a technique capable of measuring both fibrosis and liver fat content simultaneously, as a screening tool for hepatic involvement in patients with T2DM.

Material and methods : Its a retrospective study spanned from January 2019 to January 2024 and included all patients diagnosed with T2DM who underwent TE. LSM values were determined using a Fibroscan 502 touch (Echosens SA, Paris, France) with the original M or XL probe selected based on the patients body weight or subcutaneous adipose tissue thickness, as per the manufacturers guidelines. TE scans were considered reliable when a minimum of 10 successful acquisitions were obtained, and the interquartile range-to-median ratio of the 10 acquisitions was ≤0.3.

Results : A total of 124 patients with T2DM who underwent TE examination were included. 46 males and 78 females. The mean BMI of the patients was 33.2±6.6 kg/m2. The mean LSM was 7.1±3.4 kPa. LSM values exhibited significant correlations with BMI (p<0.001) and AST (p<0.001). The mean CAP value was 317±54 dB/m. Univariate correlation analyses demonstrated significant associations between CAP values and BMI (p<0.001). We found higher ALT levels (p<0.05) in patients with F3/F4 fibrosis. Both patients with mild and severe steatosis had higher ALT levels than those without (both p<0.05). However, ALT values did not differ significantly according to steatosis severity (p=0.69).

Conclusion : Our results contribute to the existing body of evidence across various studies, approving the clinical utility of LSM and CAP for concurrent screening of liver fibrosis and steatosis in patients with T2DM.