PMID- 33303638
OWN - NLM
STAT- MEDLINE
DCOM- 20210820
LR  - 20210820
IS  - 1935-5548 (Electronic)
IS  - 0149-5992 (Linking)
VI  - 44
IP  - 2
DP  - 2021 Feb
TI  - High Prevalence of Advanced Liver Fibrosis Assessed by Transient Elastography 
      Among U.S. Adults With Type 2 Diabetes.
PG  - 519-525
LID - 10.2337/dc20-1778 [doi]
AB  - OBJECTIVE: Type 2 diabetes mellitus (T2DM) is an important risk factor for the 
      progression of metabolic liver disease to advanced fibrosis. Here, we provide an 
      estimate of the prevalence of steatosis and fibrosis in U.S. adults with T2DM on 
      the basis of transient elastography (TE) and identify factors associated with 
      these conditions. RESEARCH DESIGN AND METHODS: This is a cross-sectional study of 
      U.S. adults with T2DM participating in the 2017-2018 cycle of the National Health 
      and Nutrition Examination Survey who were evaluated by TE. Hepatic steatosis and 
      fibrosis were diagnosed by the median value of controlled attenuation parameter 
      (CAP) and liver stiffness measurement (LSM), respectively. RESULTS: Among the 825 
      patients with reliable TE examination results, 484 (53.7%) were assessed using 
      the M probe and 341 (46.3%) using the XL probe. Liver steatosis (CAP >/=274 dB/m), 
      advanced fibrosis (LSM >/=9.7 kPa), and cirrhosis (LSM >/=13.6 kPa) were present in 
      73.8% (95% CI 68.5%-78.5%), 15.4% (95% CI 12.2%-19.0%), and 7.7% (95% CI 
      4.8%-11.9%) of patients, respectively. The mean +/- SE age of patients with 
      advanced fibrosis and cirrhosis was 63.7 +/- 2.2 years and 57.8 +/- 1.6 years, 
      respectively. In the multivariable logistic regression model, BMI, non-Black 
      race, and ALT levels were independent predictors of steatosis; and BMI, non-Black 
      race, and AST and gamma-glutamyltranspeptidase levels were independent predictors of 
      advanced fibrosis. CONCLUSIONS: Prevalence of both liver steatosis and fibrosis 
      is high in patients with T2DM from the United States and obesity is a major risk 
      factor. Our results support the screening of these conditions among patients with 
      diabetes.
CI  - (c) 2020 by the American Diabetes Association.
FAU - Ciardullo, Stefano
AU  - Ciardullo S
AD  - Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy.
AD  - Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
FAU - Monti, Tommaso
AU  - Monti T
AD  - Department of Statistics and Quantitative Methods, University of Milano Bicocca, 
      Milan, Italy.
FAU - Perseghin, Gianluca
AU  - Perseghin G
AUID- ORCID: 0000-0002-3024-0457
AD  - Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy 
      gianluca.perseghin@policlinicodimonza.it.
AD  - Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
LA  - eng
SI  - figshare/10.2337/figshare.13222142
PT  - Journal Article
DEP - 20201210
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cross-Sectional Studies
MH  - *Diabetes Mellitus, Type 2/complications/diagnostic imaging/epidemiology
MH  - *Elasticity Imaging Techniques
MH  - Humans
MH  - Liver/diagnostic imaging/pathology
MH  - Liver Cirrhosis/diagnostic imaging/epidemiology/pathology
MH  - Middle Aged
MH  - *Non-alcoholic Fatty Liver Disease/diagnostic imaging/epidemiology/pathology
MH  - Nutrition Surveys
MH  - Prevalence
MH  - United States/epidemiology
EDAT- 2020/12/12 06:00
MHDA- 2021/08/21 06:00
CRDT- 2020/12/11 05:50
PHST- 2020/07/15 00:00 [received]
PHST- 2020/11/01 00:00 [accepted]
PHST- 2020/12/12 06:00 [pubmed]
PHST- 2021/08/21 06:00 [medline]
PHST- 2020/12/11 05:50 [entrez]
AID - dc20-1778 [pii]
AID - 10.2337/dc20-1778 [doi]
PST - ppublish
SO  - Diabetes Care. 2021 Feb;44(2):519-525. doi: 10.2337/dc20-1778. Epub 2020 Dec 10.