Type 2 diabetes increases the risk for non-alcoholic fatty liver disease (NAFLD), but current guidelines do not clearly explain screening for NAFLD in diabetic patients. A study investigated the strategy of screening diabetic patients by FibroScan.

Controlled attenuation parameter (CAP) and liver stiffness measurements (LSM) were used for assessing Liver fat and fibrosis by FibroScan. Advanced fibrosis was identified by Probe-specific LSM cut-offs.

The observations of the study were as follows-

• 1918 patients were examined
• 8% of patients demonstrated valid CAP and 98.2% demonstrated a reliable LSM.
• 8% of patients had an increased CAP.
• 7% of patients had an increased LSM.
• Multivariable analysis found female gender, higher body mass index, triglycerides, fasting plasma glucose and alanine aminotransferase (ALT) and non-insulin use has an increased CAP.
• Longer duration of diabetes, higher body mass index, increased ALT and spot urine albumin: creatinine ratio and lower high-density lipoprotein-cholesterol demonstrated an increased LSM.
• Among 94 patients (80% had increased LSM) who underwent liver biopsy, 56% had steatohepatitis and 50% had F3-4 disease.

It was thus concluded that there exists a high prevalence of NAFLD and advanced fibrosis among Diabetic patients, and obesity and dyslipidaemia increases risk thus must be targeted for liver assessment. Screening for NAFLD and/or advanced fibrosis is recommended in patients with type 2 diabetes.

Source: Gut. 2016 Aug;65(8):1359-68. doi: 10.1136/gutjnl-2015-309265. Epub 2015 Apr 14. PMID: 25873639.