PMID- 31612634
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1478-3231 (Electronic)
IS  - 1478-3223 (Linking)
VI  - 40
IP  - 2
DP  - 2020 Feb
TI  - Liver fibrosis by FibroScan((R)) independently of established cardiovascular risk 
      parameters associates with macrovascular and microvascular complications in 
      patients with type 2 diabetes.
PG  - 347-354
LID - 10.1111/liv.14274 [doi]
AB  - BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes 
      mellitus (T2DM) are closely associated, and liver fibrosis has been related to 
      macrovascular complications. We examined whether liver fibrosis, diagnosed by 
      FibroScan((R)) , correlates with chronic vascular complications in a cohort of 
      T2DM. METHODS: We recruited 394 outpatients with T2DM attending five Italian 
      diabetes centres who underwent liver ultrasonography (US), FibroScan((R)) and 
      extensive evaluation of macrovascular and microvascular diabetic complications. 
      RESULTS: Steatosis by US was present in 89%. Almost all patients (96%) were on 
      hypoglycaemic drugs, 58% had at least one chronic vascular complication, 19% a 
      macrovascular complication (prior myocardial infarction and/or ischaemic stroke) 
      and 33% a microvascular one (26% chronic kidney disease [CKD]; 16% retinopathy; 
      6% neuropathy). In all, 171 (72%) patients had CAP >/= 248dB/m (ie hepatic 
      steatosis), whereas 83 (21%) patients had LSM >/= 7.0/6.2 kPa (M/XL probes) 
      (significant liver fibrosis). CAP was not associated with any macro/microvascular 
      complications, whereas LSM >/= 7.0/6.2 kPa was independently associated with prior 
      cardiovascular disease (adjusted OR 3.3, 95%CI 1.2-8.8; P = .02) and presence of 
      microvascular complications (adjusted OR 4.2, 95%CI 1.5-11.4; P = .005), mainly 
      CKD (adjusted OR 3.6, 95%CI 1.3-10.1; P = .01) and retinopathy (adjusted OR 3.7, 
      CI 95% 1.2-11.9; P = .02). Neither diabetes duration nor haemoglobin A1c differed 
      according to CAP or LSM values. CONCLUSION: Significant fibrosis, detected by 
      FibroScan((R)) , is independently associated with increased prevalence of 
      macrovascular and microvascular complications, thus opening a new scenario in the 
      use of this tool for a comprehensive evaluation of hepatic and vascular 
      complications in patients with T2DM.
CI  - (c) 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Lombardi, Rosa
AU  - Lombardi R
AUID- ORCID: 0000-0001-6958-927X
AD  - Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, 
      Policlinico Hospital, University of Milan, Milan, Italy.
FAU - Airaghi, Lorena
AU  - Airaghi L
AUID- ORCID: 0000-0001-5466-8151
AD  - Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, 
      Policlinico Hospital, University of Milan, Milan, Italy.
FAU - Targher, Giovanni
AU  - Targher G
AUID- ORCID: 0000-0002-4325-3900
AD  - Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, 
      University Hospital of Verona, Verona, Italy.
FAU - Serviddio, Gaetano
AU  - Serviddio G
AUID- ORCID: 0000-0002-6424-7841
AD  - Centro C.U.R.E, Department of Medical and Surgical Sciences, University of 
      Foggia, Foggia, Italy.
FAU - Maffi, Gabriele
AU  - Maffi G
AD  - Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, 
      Policlinico Hospital, University of Milan, Milan, Italy.
FAU - Mantovani, Alessandro
AU  - Mantovani A
AUID- ORCID: 0000-0002-7271-6329
AD  - Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, 
      University Hospital of Verona, Verona, Italy.
FAU - Maffeis, Claudio
AU  - Maffeis C
AD  - Pediatric Diabetes and Metabolic Disorders Unit, Department of Surgical Sciences, 
      Dentistry, and Pediatrics, and Gynaecology, University Hospital of Verona, 
      Verona, Italy.
FAU - Colecchia, Antonio
AU  - Colecchia A
AD  - Gastroenterology Unit, Azienda Ospedaliera Universitaria Integrata of Verona, 
      Verona, Italy.
FAU - Villani, Rosanna
AU  - Villani R
AD  - Centro C.U.R.E, Department of Medical and Surgical Sciences, University of 
      Foggia, Foggia, Italy.
FAU - Rinaldi, Luca
AU  - Rinaldi L
AD  - Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, 
      University of Campania Luigi Vanvitelli, Naples, Italy.
FAU - Orsi, Emanuela
AU  - Orsi E
AD  - Department of Medical Science, Endocrinology and Diabetes Unit, Ca' Granda IRCCS 
      Foundation, Policlinico Hospital, University of Milan, Milan, Italy.
FAU - Pisano, Giuseppina
AU  - Pisano G
AD  - Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, 
      Policlinico Hospital, University of Milan, Milan, Italy.
FAU - Adinolfi, Luigi E
AU  - Adinolfi LE
AUID- ORCID: 0000-0001-8453-4912
AD  - Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, 
      University of Campania Luigi Vanvitelli, Naples, Italy.
FAU - Fargion, Silvia
AU  - Fargion S
AUID- ORCID: 0000-0003-0631-6666
AD  - Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, 
      Policlinico Hospital, University of Milan, Milan, Italy.
FAU - Fracanzani, Anna L
AU  - Fracanzani AL
AUID- ORCID: 0000-0001-5918-0171
AD  - Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, 
      Policlinico Hospital, University of Milan, Milan, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20191031
PL  - United States
TA  - Liver Int
JT  - Liver international : official journal of the International Association for the 
      Study of the Liver
JID - 101160857
SB  - IM
MH  - *Brain Ischemia
MH  - *Cardiovascular Diseases
MH  - *Diabetes Mellitus, Type 2/complications
MH  - *Elasticity Imaging Techniques
MH  - Heart Disease Risk Factors
MH  - Humans
MH  - Liver Cirrhosis/diagnostic imaging
MH  - *Non-alcoholic Fatty Liver Disease/diagnostic imaging
MH  - Risk Factors
MH  - *Stroke
OTO - NOTNLM
OT  - NAFLD
OT  - cardiovascular disease
OT  - liver stiffness measurement
OT  - microvascular complications
OT  - type 2 diabetes
EDAT- 2019/10/16 06:00
MHDA- 2021/06/22 06:00
CRDT- 2019/10/16 06:00
PHST- 2019/07/08 00:00 [received]
PHST- 2019/09/01 00:00 [revised]
PHST- 2019/09/23 00:00 [accepted]
PHST- 2019/10/16 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2019/10/16 06:00 [entrez]
AID - 10.1111/liv.14274 [doi]
PST - ppublish
SO  - Liver Int. 2020 Feb;40(2):347-354. doi: 10.1111/liv.14274. Epub 2019 Oct 31.