Screening for Non-alcoholic Liver Disease in Type 2 Diabetic Patients and its Association with Age, BMI and Duration of Diabetes Mellitus- A Cross-sectional Study
There exists a bidirectional relationship between Non-Alcoholic Fatty Liver Disease (NAFLD) and Type 2 Diabetes. While currently there are no NAFLD test recommendations for people with diabetes, only several non-invasive methods for recognizing patients with NASH or fibrosis have been proposed. Hence, there is a lack of validated decisional algorithms that would be adequate for clinical practice. Ajoy Tewari and colleagues conducted research under the title “Screening for Non-alcoholic Liver Disease in Type 2 Diabetic Patients and its Association with Age, BMI, and Duration of Diabetes Mellitus- A Cross-sectional Study” published in the Journal of Clinical and Diagnostic Research. The summary of this paper is given below:
Objective:
To screen people with T2DM for NAFLD
To evaluate its association with age, Body Mass Index (BMI), and duration of diabetes.
Method:
It was a prospective cross-sectional study conducted on Type 2 Diabetes Mellitus (T2DM) patients who visited the study center for consultation between July 2019 and November 2019. A total of 287 patients were included. They were subjected to the FibroScan test and LSM was also conducted. The other variables-age, gender, height, weight, duration of diabetes, HbA1c, and BMI were recorded for all subjects. The data collected were correlated using the Spearman rho test.
Findings:
The study reports that diabetes patient is at higher risk of NAFLD and advanced liver fibrosis. Increasing age, longer duration of diabetes, high BMI, and uncontrolled diabetes have a direct relation with advanced fibrosis and such people are potential targets for liver assessment. Investigators highlight a need for a proactive approach towards screening, identifying, and referral of people with diabetes for advanced fibrosis in present times. After a diagnosis of advanced fibrosis, the patient should be referred to confirmation of diagnosis with Controlled Attenuation Parameter (CAP) score and liver biopsy.
Limitation:
Due to the unavailability of the XL probe, only the M probe was used in obese patients as well. Liver stiffness could have been measured appropriately by an XL probe in obese patients. The study can be only qualified as limited screening because CAP is not performed due to unavailability. Secondly, it is unethical to perform liver biopsies in asymptomatic NAFLD patients. Hence, it’s possible that the prevalence of NAFLD reported in the study is less than the actual figures.
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