Liver and Nonliver-Related Outcomes at 2 Years Are Not Influenced by the Results of the FIB-4 Test and Liver Elastography in a Real-Life Cohort of Patients with Type 2 Diabetes

• Published in: Canadian journal of gastroenterology & hepatology Vol. 2021; pp. 5582813 - 9
• Main Authors: Grgurevic, Ivica, Salkic, Nermin, Mustapic, Sanda, Bokun, Tomislav, Podrug, Kristian, Marusic, Srecko, Rahelic, Dario, Matic, Tomas, Skurla, Viktoria, Mikolasevic, Ivana
• Format: Journal Article
• Language: English
• Published: Egypt Hindawi 2021; Hindawi Limited
• Subjects: Diabetes; Diagnostic tests; Liver diseases; Medical prognosis; Morbidity; Mortality; Multivariate analysis; Patients; Statistical analysis; Variables
• ISSN: 2291-2789; 2291-2797
• DOI: 10.1155/2021/5582813

Aims. To investigate morbidity and mortality in a real-life cohort of patients with type 2 diabetes (T2D) in relation to prevalence and severity of nonalcoholic fatty liver disease (NAFLD). Methods. Patients with T2D were referred for assessment of liver fibrosis by the FIB-4 test and liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE). Liver steatosis was quantified by the controlled attenuation parameter (CAP). These patients were followed until death or censored date. Results. Among 454 patients (52% males, mean age 62.5 years, BMI 30.9 kg/m2), 82.6% was overweight, 77.8% had fatty liver, and 9.9% and 3.1% had LSM and FIB-4 values suggestive of advanced fibrosis, respectively. During the follow-up period of median 2 years, 106 (23%) patients experienced adverse event (11% cardiovascular) and 17 (3.7%) died, whereas no liver-related morbidity or mortality was observed. Independent predictors of adverse outcomes were age and higher platelet count, while FIB-4, LSM, and CAP were not. Conclusion. In a cohort of T2D patients, no liver-related morbidity or mortality occurred during 2 years. Our patients probably have low real prevalence of advanced fibrosis which is likely overestimated by LSM ≥ 9.6 kPa. Liver fibrosis may be safely reassessed in the 2 years interval in noncirrhotic patients with T2D.