Prevalence of Hepatic Steatosis and Fibrosis in Asian Indian Individuals with Type 2 Diabetes.

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2025-07-03 DOI:10.1007/s13300-025-01764-1

Khandhulwa Chandramouli Bhuvanesswar, Brijendra Kumar Srivastava, Anandakumar Amutha, Varun Damle, Aswin Krishna, Prasanna Kumar Gupta, Phillips Routray, Dhanasekaran Killivalavan, Saravanan Jebarani, Ulagamathesan Venkatesan, Rosette James Chakkalakal, Shalimar, Janardanan Subramonia Kumar, Duvvur Nageshwar Reddy, Anand V Kulkarni, Ranjit Unnikrishnan, Ranjit Mohan Anjana, Krishna Govindarajapuram Seshadri, Viswanathan Mohan

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引用次数: 0

Abstract

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 FibroScan^R 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.

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亚洲印度2型糖尿病患者肝脂肪变性和肝纤维化的患病率

代谢功能障碍相关的脂肪变性肝病（MASLD）与糖尿病密切相关，由于其可能发展为肝硬化，因此是一个重要的健康问题。我们的目标是利用瞬时弹性成像（由巴黎Echosens公司的FibroScanR进行TE）确定2型糖尿病（T2D）患者MASLD的患病率。方法：在两家糖尿病诊所接受纤维扫描评估的1070例T2D患者（报告无酒精摄入）的回顾性数据（2020年至2024年）进行分析。采用控制衰减参数（CAP）（dB/m）对脂肪变性进行分类。结果：平均年龄为55.1±11.5岁，糖尿病病程为11.8±8.6年，体重指数（BMI）为27.9±4.8 kg/m2。S0、S1、S2和S3脂肪变性分别为24.4%、16.0%、20.1%和39.5%。无纤维化（F0-F1）者占71.4%，F2者占9.9%，F3者占9.3%，F4者占9.4%。不同程度的脂肪变性和纤维化分别出现在75.6%和28.6%，女性比男性更常见。在风险评分中，FIB-4检测纤维化的敏感性为67.2%，NFS为84.1%，APRI为40.9%，尽管后者具有更高的特异性（84.4%）。结论：TE （FibroScan）显示，超过75.6%的T2D患者有肝脂肪变性的证据，28.6%有纤维化。FIB-4、NFS和APRI在检测亚洲印度T2D患者肝纤维化方面具有不同的敏感性和特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.