medwireNews: Researchers have detected moderate or severe liver fibrosis in around one in six people with type 2 diabetes.
Kenneth Cusi (University of Florida, Gainesville, USA) and colleagues identified fibrosis in 21% of 561 outpatients with type 2 diabetes, with 5.6% having moderate fibrosis and 6.2% severe fibrosis, while 3.0% had cirrhosis.
Seventy percent of the participants had non-alcoholic fatty liver disease. This was increasingly common with higher BMI, and fibrosis was more common in those with more severe steatosis.
“That one in six patients with unsuspected disease already had fibrosis supports the notion that patients with obesity and diabetes are at the highest risk and in need of more aggressive screening,” they write in Diabetes Care.
The team adds: “An early diagnosis is important since there are current interventions that may halt or reverse the disease, with more soon to become available.”
Of note, only 18–28% of people with moderate-to-severe fibrosis had elevated liver enzymes, making these a poor screening tool.
“This reality calls for a different diagnostic approach in primary care clinics, where imaging may play a bigger role,” say Cusi et al.
Their screening approach involved elastography plus fibrosis diagnostic scores. Results from the latter correlated well with liver biopsy findings in participants who agreed to undergo the procedure, but the team notes that the scores depend on liver enzymes and so were helpful only in the minority of participants who had elevated levels.
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