PMID- 28570615
OWN - NLM
STAT- MEDLINE
DCOM- 20170926
LR  - 20190208
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 6
DP  - 2017
TI  - Liver biopsy in type 2 diabetes mellitus: Steatohepatitis represents the sole 
      feature of liver damage.
PG  - e0178473
LID - 10.1371/journal.pone.0178473 [doi]
LID - e0178473
AB  - Recent studies report a prevalence of non-alcoholic fatty liver disease (NAFLD) 
      of between 70% and 80% in patients with metabolic syndrome (MS) and type 2 
      diabetes mellitus (T2DM). Nevertheless, it is not possible to differentiate 
      between simple steatosis and non-alcoholic steatohepatitis (NASH) with 
      non-invasive tests. The aim of this study was to differentiate between simple 
      steatosis and NASH by liver biopsy in patients with hypertransaminasemia and MS 
      or T2DM. Two hundred and fifteen patients with increased ALT levels and MS, and 
      136 patients at their first diagnosis of T2DM regardless of ALT values were 
      consecutively admitted to a tertiary hepatology center between January 2004 and 
      November 2014. Exclusion criteria were other causes of liver disease/ALT 
      increase. Each patient underwent a clinical, laboratory and ultrasound 
      evaluation, and a liver biopsy. Gender distribution, age, and body mass index 
      were similar in the two groups of patients, whereas cholesterol levels, glycemia 
      and blood pressure were significantly different between the two groups. The 
      prevalence of NAFLD was 94.82% in MS patients and 100% in T2DM patients. NASH was 
      present in 58.52% of MS patients and 96.82% of T2DM. Consequently, this study 
      reveals that, by using liver biopsy, almost all patients with T2DM or MS have 
      NAFLD, which in patients with T2DM means NASH. Importantly, it suggests that NASH 
      may be one of the early complications of T2DM due to its pathophysiological 
      correlation with insulin resistance.
FAU - Masarone, Mario
AU  - Masarone M
AD  - Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.
FAU - Rosato, Valerio
AU  - Rosato V
AD  - Internal Medicine and Hepatology Department, University of Campania "L. 
      Vanvitelli", Naples, Italy.
FAU - Aglitti, Andrea
AU  - Aglitti A
AD  - Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.
FAU - Bucci, Tommaso
AU  - Bucci T
AD  - Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.
FAU - Caruso, Rosa
AU  - Caruso R
AD  - Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.
FAU - Salvatore, Teresa
AU  - Salvatore T
AD  - Internal Medicine and Hepatology Department, University of Campania "L. 
      Vanvitelli", Naples, Italy.
FAU - Sasso, Ferdinando Carlo
AU  - Sasso FC
AD  - Internal Medicine and Hepatology Department, University of Campania "L. 
      Vanvitelli", Naples, Italy.
FAU - Tripodi, Marie Francoise
AU  - Tripodi MF
AD  - Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.
FAU - Persico, Marcello
AU  - Persico M
AUID- ORCID: 0000-0002-1399-6498
AD  - Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.
LA  - eng
PT  - Journal Article
DEP - 20170601
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biopsy
MH  - Diabetes Mellitus, Type 2/*complications/pathology
MH  - Fatty Liver/complications/*pathology
MH  - Female
MH  - Humans
MH  - Liver/*pathology
MH  - Male
MH  - Middle Aged
PMC - PMC5453539
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2017/06/02 06:00
MHDA- 2017/09/28 06:00
PMCR- 2017/06/01
CRDT- 2017/06/02 06:00
PHST- 2016/10/24 00:00 [received]
PHST- 2017/05/13 00:00 [accepted]
PHST- 2017/06/02 06:00 [entrez]
PHST- 2017/06/02 06:00 [pubmed]
PHST- 2017/09/28 06:00 [medline]
PHST- 2017/06/01 00:00 [pmc-release]
AID - PONE-D-16-42337 [pii]
AID - 10.1371/journal.pone.0178473 [doi]
PST - epublish
SO  - PLoS One. 2017 Jun 1;12(6):e0178473. doi: 10.1371/journal.pone.0178473. 
      eCollection 2017.