Screening for Liver Fibrosis by Using a Noninvasive Biomarker in Patients With Diabetes

• Published in: Clinical gastroenterology and hepatology Vol. 6; no. 7; pp. 828 - 831
• Main Authors: Jacqueminet, Sophie, Lebray, Pascal, Morra, Rachel, Munteanu, Mona, Devers, Laure, Messous, Djamila, Bernard, Maguy, Hartemann–Heurtier, Agnes, Imbert–Bismut, Francoise, Ratziu, Vlad, Grimaldi, Andre, Poynard, Thierry
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2008
• Subjects: Adult; Aged; Biomarkers; Biopsy; Diabetes Complications; Elasticity Imaging Techniques; Endoscopy; Female; Gastroenterology and Hepatology; Humans; Liver - pathology; Liver Cirrhosis - epidemiology; Liver Function Tests - methods; Male; Mass Screening - methods; Middle Aged; Prevalence; Prospective Studies; Severity of Illness Index; Ultrasonography; positive predictive value; NAFLD; OR; CI; HCC; odds ratio; FT; FibroTest; nonalcoholic fatty liver disease; GGT; PPV; γ-glutamyltranspeptidase; confidence interval; hepatocellular carcinoma
• ISSN: 1542-3565; 1542-7714
• DOI: 10.1016/j.cgh.2008.03.005

Background & Aims: Patients with diabetes are at risk for nonalcoholic fatty liver disease leading to advanced fibrosis, cirrhosis, and liver cancer. We examined the efficacy of a screening strategy with a noninvasive fibrosis biomarker (FibroTest) in patients with diabetes. Methods: We prospectively studied 1131 consecutive patients without a history of liver disease seen for diabetes. The biomarker data were obtained, and patients with presumed advanced fibrosis were reinvestigated by a hepatologist using elastography and, if necessary, ultrasonography, endoscopy, or liver biopsy. Results: The biomarker predicted advanced fibrosis in 63 of 1131 (5.6%) patients. A total of 45 patients was reinvestigated, and advanced fibrosis was confirmed in 32 patients, a 2.8% (32/1131) prevalence of confirmed advanced fibrosis, 5 cases of cirrhosis, and 4 cases of hepatocellular carcinoma. In the population with type 2 diabetes who were 45 years or older, the prevalence of confirmed advanced fibrosis was 4.3% (30/696), and hepatocellular carcinoma was 5.7 of 1000 (4/696). Conclusions: The fibrosis biomarker might be used for the detection of advanced fibrosis in patients with type 2 diabetes.