Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
Prevalence of Hepatic Steatosis and Fibrosis in Asian Indian Individuals with Type 2 Diabetes.
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Bhuvanesswar Khandhulwa Chandramouli, Srivastava Brijendra Kumar, Amutha Anandakumar, Damle Varun, Krishna Aswin, Gupta Prasanna Kumar, Routray Phillips, Killivalavan Dhanasekaran, Jebarani Saravanan, Venkatesan Ulagamathesan, Chakkalakal Rosette James, Shalimar, Kumar Janardanan Subramonia, Nageshwar Reddy Duvvur, Kulkarni Anand V, Unnikrishnan Ranjit, Anjana Ranjit Mohan, Seshadri Krishna Govindarajapuram, Mohan Viswanathan
Аннотация
INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with diabetes mellitus, representing a significant health concern owing to its potential progression to cirrhosis of the liver. We aim to determine the prevalence of MASLD using transient elastography (TE by FibroScanR by Echosens, Paris) in individuals with type 2 diabetes (T2D).
METHODS: The retrospective data (between 2020 and 2024) of 1070 individuals with T2D (who reported no alcohol intake) who underwent FibroScan assessment at two diabetes clinics were included for analysis. Steatosis was classified using controlled attenuation parameters (CAP) (dB/m) as: S0 (< 238 dB/m), S1 (238-260 dB/m), S2 (260-290 dB/m), and S3 (290-400 dB/m). Liver stiffness measurement (LSM)(kPa) was graded as: F0-F1 (no significant fibrosis, ≤ 8.1 kPa), F2 (≥ 8.2-9.6 kPa), F3 (≥ 9.7-13.5 kPa), and F4 (≥ 13.6 kPa). Fibrosis 4 score (FIB-4), nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS), and aspartate transaminase (AST)-to-platelet ratio index (APRI) were calculated for LSM.
RESULTS: The mean age, duration of diabetes, and body mass index (BMI) were 55.1 ± 11.5 yrs, 11.8 ± 8.6 years, and 27.9 ± 4.8 kg/m2, respectively. S0, S1, S2, and S3 steatosis were present in 24.4%, 16.0%, 20.1%, and 39.5%, respectively. Fibrosis was absent (F0-F1) in 71.4%, while F2 was present in 9.9%, F3 in 9.3%, and F4 in 9.4%. Any degree of steatosis and fibrosis were present in 75.6% and 28.6%, respectively, and were more frequently observed in women than in men. Among the risk scores, the sensitivity for detecting fibrosis was 67.2% for FIB-4, 84.1% for NFS, and 40.9% for APRI, although the latter had higher specificity (84.4%).
CONCLUSIONS: More than 75.6% of individuals with T2D have evidence of hepatic steatosis and 28.6% have fibrosis, as indicated by TE (FibroScan). FIB-4, NFS, and APRI have variable sensitivity and specificity for detecting hepatic fibrosis in Asian Indian individuals with T2D.
METHODS: The retrospective data (between 2020 and 2024) of 1070 individuals with T2D (who reported no alcohol intake) who underwent FibroScan assessment at two diabetes clinics were included for analysis. Steatosis was classified using controlled attenuation parameters (CAP) (dB/m) as: S0 (< 238 dB/m), S1 (238-260 dB/m), S2 (260-290 dB/m), and S3 (290-400 dB/m). Liver stiffness measurement (LSM)(kPa) was graded as: F0-F1 (no significant fibrosis, ≤ 8.1 kPa), F2 (≥ 8.2-9.6 kPa), F3 (≥ 9.7-13.5 kPa), and F4 (≥ 13.6 kPa). Fibrosis 4 score (FIB-4), nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS), and aspartate transaminase (AST)-to-platelet ratio index (APRI) were calculated for LSM.
RESULTS: The mean age, duration of diabetes, and body mass index (BMI) were 55.1 ± 11.5 yrs, 11.8 ± 8.6 years, and 27.9 ± 4.8 kg/m2, respectively. S0, S1, S2, and S3 steatosis were present in 24.4%, 16.0%, 20.1%, and 39.5%, respectively. Fibrosis was absent (F0-F1) in 71.4%, while F2 was present in 9.9%, F3 in 9.3%, and F4 in 9.4%. Any degree of steatosis and fibrosis were present in 75.6% and 28.6%, respectively, and were more frequently observed in women than in men. Among the risk scores, the sensitivity for detecting fibrosis was 67.2% for FIB-4, 84.1% for NFS, and 40.9% for APRI, although the latter had higher specificity (84.4%).
CONCLUSIONS: More than 75.6% of individuals with T2D have evidence of hepatic steatosis and 28.6% have fibrosis, as indicated by TE (FibroScan). FIB-4, NFS, and APRI have variable sensitivity and specificity for detecting hepatic fibrosis in Asian Indian individuals with T2D.