Background Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are closely associated with type 2 diabetes mellitus (T2DM). NAFLD is an increasingly common cause of chronic liver disease. Recently authors have use the term MAFLD (metabolic dysfunction-associated fatty liver disease) using metabolic dysfunctions as diagnostic criteria. Materials and methods Between March 2022 and June 2023, 4,395 hepatic elastography were performed in our clinics. We analyzed data of 1,000 not selected subjects, 637 males and 363 females. Results Average age was 62 ± 11 years and average body mass index (BMI) 27.1 ± 5.2 kg/m2. Most patients (42.5%) were overweight and 23% were obese: 16.4% I grade of obesity (BMI 30-34.9 kg/m2), 5.5% II grade (BMI 35-39.9 kg/m2) and 1% III grade (BMI >40 kg/m2). Average glycated hemoglobin value was 7.1 ± 1.2% (HbA1c range 5-14.8%). Total cholesterol, HDL cholesterol, triglycerides, creatinine and liver enzymes were regular. Hepatic elastography was normal (kPa ≤5.8) in most patients: 545 patients (54.5%) had no hepatic fibrosis (F0/F1), 455 patients (45.5%) had varying degrees of hepatic fibrosis. 271 patients were classified with a grade of F2, 115 patients with F3 and 69 patients with F4. We compared metabolic characteristics of patients without fibrosis (F0/F1) versus second group (F2-F4). No statistical differences were found in sex or metabolic targets. Patients with fibrosis had a statistically higher weight and, consequently, higher BMI than patients without fibrosis (p<0.001). Liver enzyme levels were higher in patients with fibrosis compared to patients without fibrosis with strong statistical significance (p<0.001). Conclusions We identified advanced fibrosis (F3-F4) in 18.4% of subjects. Patients with liver fibrosis have higher BMI. Nowadays is particularly important screening diabetic population for MAFLD using non-invasive methods to establish targeted treatments with drugs of proven efficacy.
Key words: T2DM, MAFLD, hepatic elastography, hepatic fibrosis, BMI, liver enzyme level
Valutazione della prevalenza della Metabolic dysfunction-Associated Fatty Liver Disease mediante elastometria epatica in pazienti diabetici ambulatoriali: esperienza di un singolo centro ad alto volume
Francesca Cecoli, Eleonora Monti, Alberto Rebora, Gianni Testino, Luigi Carlo Bottaro, Enrico Torre