The status of liver fibrosis evaluated by non-alcoholic fatty liver disease fibrosis score in hospitalized patients with type 2 diabetes mellitus
10.3760/cma.j.issn.1000-6699.2014.11.004
- VernacularTitle:利用非酒精性脂肪性肝病纤维化评分评估住院2型糖尿病患者的肝脏纤维化状况
- Author:
Hua BIAN
;
Linshan ZHANG
;
Hongmei YAN
;
Mingfeng XIA
;
Xinxia CHANG
;
Xin GAO
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus,type 2;
Non-alcoholic fatty liver disease;
Fibrosis
- From:
Chinese Journal of Endocrinology and Metabolism
2014;30(11):960-965
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the severity of non-alcoholic fatty liver disease(NAFLD) and progressive liver fibrosis(stage>2)in hospitalized patients with type 2 diabetes mellitus(T2DM) by using NAFLD fibrosis score (NFS).The risk factors associated with progressive fibrosis were also analyzed.Methods A total of 721 hospitalized patients with T2DM and uhrasound verified NAFLD were involved.The history information and laboratory examinations were collected,NFS was calculated.The low cutoff score (-1.455) of NFS was used to exclude,and high cutoff score (0.676) to further accurately diagnose progressive fibrosis.Results (1) A total of 721 subjects (male/female 371/350) were diagnosed as NAFLD by ultrasound.In those subjects,173 patients were with progressive fibrosis (24.0%),111 patients without progressive fibrosis (15.4%),and 437 patients (60.6%) with NFS ranged from-1.455 to 0.676.(2) Aging,raised body mass index,aspartate amino transferase/alanine aminotransferase (AST/ALT) ratio,lowered albumin,and platelet were risk factors for progressive fibrosis of NAFLD.In addition,NFS was positively correlated with duration of diabetes,waist circumference,SBP,glycated albumin (GA),and GA/HbA1c(all P<0.01),and negatively with red blood cell count,hemoglobin,white blood cell count (WBC),total cholesterol (TC),triglyceride,apolipoprotein-B,ALT,γ-glutamyltranspeptidase (all P<0.01),AST,low-density lipoprotein cholesterol (all P<0.05).(3) Logistic stepwise regression analysis showed diabetes duration,waist circunference,and GA were positively correlated with progressive liver fibrosis(OR =1.182,1.076,1.074,all P<0.01),and negatively with WBC and TC (OR =0.613,0.703,all P<0.01).Conclusions The detection rate of progressive fibrosis in patients with NAFLD and T2DM was approximately 24.0% by applying NFS.Only 15.4% of those subjects could be excluded from progressive fibrosis.It suggests that we should be alert to the risk of liver fibrosis in patients with type 2 diabetes.