PMID- 26369383
OWN - NLM
STAT- MEDLINE
DCOM- 20160706
LR  - 20220321
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Print)
IS  - 0269-2813 (Linking)
VI  - 43
IP  - 1
DP  - 2016 Jan
TI  - Non-invasive screening of diabetics in primary care for NAFLD and advanced 
      fibrosis by MRI and MRE.
PG  - 83-95
LID - 10.1111/apt.13405 [doi]
AB  - BACKGROUND: Current guidelines do not recommend screening for non-alcoholic fatty 
      liver disease (NAFLD) or advanced fibrosis. Patients with type 2 diabetes 
      mellitus (T2DM) are known to be at increased risk for NAFLD and advanced 
      fibrosis. AIM: To assess the feasibility in diabetics in a primary care setting 
      of screening for NAFLD and advanced fibrosis, by using non-invasive magnetic 
      resonance imaging (MRI) to estimate the hepatic proton density fat fraction 
      (MRI-PDFF) and magnetic resonance elastography (MRE) to estimate hepatic 
      stiffness. METHODS: We performed a cross-sectional analysis of a prospective 
      study that included 100 (53% men) consecutively enrolled diabetics who did not 
      have any other aetiology of liver disease. All patients underwent a standardised 
      research visit, laboratory tests, MRI-PDFF, and MRE. RESULTS: Mean (+/-s.d.) age 
      and body mass index (BMI) was 59.7 (+/-11.2) years and 30.8 (+/-6.5) kg/m(2) , 
      respectively. The prevalence of NAFLD (defined as MRI-PDFF >/=5%) and advanced 
      fibrosis (defined as MRE >/=3.6 kPa) was 65% and 7.1%, respectively. One patient 
      with advanced fibrosis had definite hepatocellular carcinoma. When compared to 
      those without NAFLD, patients with NAFLD were younger (P = 0.028) and had higher 
      mean BMI (P = 0.0008), waist circumference (P < 0.0001) and prevalence of 
      metabolic syndrome (84.6% vs. 40.0%, P < 0.0001). Only 26% of those with NAFLD 
      had elevated alanine aminotransferase. CONCLUSIONS: This proof-of-concept study 
      demonstrates that T2DM has significant rates of both NAFLD and advanced fibrosis. 
      Concomitant screening for NAFLD and advanced fibrosis by using MRI-proton density 
      fat fraction and magnetic resonance elastography in T2DM is feasible and may be 
      considered after validation in a larger cohort.
CI  - (c) 2015 John Wiley & Sons Ltd.
FAU - Doycheva, I
AU  - Doycheva I
AD  - NAFLD Translational Research Unit, Department of Medicine, University of 
      California, San Diego, La Jolla, CA, USA.
FAU - Cui, J
AU  - Cui J
AD  - NAFLD Translational Research Unit, Department of Medicine, University of 
      California, San Diego, La Jolla, CA, USA.
FAU - Nguyen, P
AU  - Nguyen P
AD  - NAFLD Translational Research Unit, Department of Medicine, University of 
      California, San Diego, La Jolla, CA, USA.
AD  - Division of Gastroenterology, Department of Medicine, University of California, 
      San Diego, La Jolla, CA, USA.
FAU - Costa, E A
AU  - Costa EA
AD  - Liver Imaging Group, Department of Radiology, University of California, San 
      Diego, La Jolla, CA, USA.
FAU - Hooker, J
AU  - Hooker J
AD  - Liver Imaging Group, Department of Radiology, University of California, San 
      Diego, La Jolla, CA, USA.
FAU - Hofflich, H
AU  - Hofflich H
AD  - Division of General Internal Medicine, Department of Medicine, University of 
      California, San Diego, La Jolla, CA, USA.
FAU - Bettencourt, R
AU  - Bettencourt R
AD  - Division of Epidemiology, Department of Family and Preventive Medicine, 
      University of California, San Diego, La Jolla, CA, USA.
FAU - Brouha, S
AU  - Brouha S
AD  - Department of Radiology, University of California, San Diego, La Jolla, CA, USA.
FAU - Sirlin, C B
AU  - Sirlin CB
AD  - Liver Imaging Group, Department of Radiology, University of California, San 
      Diego, La Jolla, CA, USA.
FAU - Loomba, R
AU  - Loomba R
AD  - NAFLD Translational Research Unit, Department of Medicine, University of 
      California, San Diego, La Jolla, CA, USA.
AD  - Division of Gastroenterology, Department of Medicine, University of California, 
      San Diego, La Jolla, CA, USA.
AD  - Division of Epidemiology, Department of Family and Preventive Medicine, 
      University of California, San Diego, La Jolla, CA, USA.
LA  - eng
GR  - 5TL1TR000098-05/TR/NCATS NIH HHS/United States
GR  - K23 DK090303/DK/NIDDK NIH HHS/United States
GR  - TL1 TR000098/TR/NCATS NIH HHS/United States
GR  - K23-DK090303/DK/NIDDK NIH HHS/United States
GR  - R01 DK106419/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20150915
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
SB  - IM
CIN - Aliment Pharmacol Ther. 2016 Jan;43(1):163. PMID: 26638929
MH  - Aged
MH  - Body Mass Index
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Elasticity Imaging Techniques
MH  - Female
MH  - Humans
MH  - Liver Cirrhosis/*diagnosis/*epidemiology
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Non-alcoholic Fatty Liver Disease/*diagnosis/*epidemiology
MH  - Prevalence
MH  - Primary Health Care/*methods
MH  - Prospective Studies
MH  - Waist Circumference
PMC - PMC4673036
MID - NIHMS719855
COIS- All authors report no conflicts of interest.
EDAT- 2015/09/16 06:00
MHDA- 2016/07/07 06:00
PMCR- 2017/01/01
CRDT- 2015/09/16 06:00
PHST- 2015/07/08 00:00 [received]
PHST- 2015/07/29 00:00 [revised]
PHST- 2015/08/26 00:00 [revised]
PHST- 2015/08/26 00:00 [accepted]
PHST- 2015/09/16 06:00 [entrez]
PHST- 2015/09/16 06:00 [pubmed]
PHST- 2016/07/07 06:00 [medline]
PHST- 2017/01/01 00:00 [pmc-release]
AID - 10.1111/apt.13405 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2016 Jan;43(1):83-95. doi: 10.1111/apt.13405. Epub 2015 
      Sep 15.