PMID- 35885657 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230308 IS - 2075-4418 (Print) IS - 2075-4418 (Electronic) IS - 2075-4418 (Linking) VI - 12 IP - 7 DP - 2022 Jul 20 TI - Simultaneously Screening for Liver Steatosis and Fibrosis in Romanian Type 2 Diabetes Mellitus Patients Using Vibration-Controlled Transient Elastography with Controlled Attenuation Parameter. LID - 10.3390/diagnostics12071753 [doi] LID - 1753 AB - Non-alcoholic fatty liver disease (NAFLD) is a common finding among patients with type 2 diabetes mellitus (T2DM). Between NAFLD and T2DM exist a bidirectional relationship. Patients with T2DM are at high risk for NAFLD, and evidence suggests that T2DM is linked to progressive NAFLD and poor liver outcomes. NAFLD promotes the development of T2DM and leads to a substantial increase in the risk of T2DM complications. This study aimed to assess the prevalence of liver steatosis and fibrosis in patients with T2DM from north-eastern Romania by using Vibration-Controlled Transient Elastography (VCTE) with Controlled Attenuation Parameter (CAP), which is a non-invasive method and can assess simultaneously liver steatosis and fibrosis. In total, 424 consecutive patients with T2DM were enrolled and evaluated using VCTE with CAP from January 2020 to January 2022. Clinical and laboratory data were recorded in all patients. For the CAP score, we used the following cut-offs: mild steatosis (S1)-274 dB/m, moderate steatosis (S2)-290 dB/m, and severe steatosis (S3)-302 dB/m. For liver fibrosis, to differentiate between fibrosis stages, the cut-off values were F >/= 8.2 kPa for significant fibrosis (F2), F >/= 9.7 kPa for advanced fibrosis (F3), and F >/= 13.6 kPa for cirrhosis (F4). In total, 380 diabetic patients (72.6%) had liver steatosis (51.3% females, the mean age of 55.22 +/- 10.88 years, mean body mass index (BMI) 29.12 +/- 5.64 kg/m2). Among them, 26 (8.4%) patients had moderate liver steatosis (S2) and 242 (78.5%) patients had severe hepatic steatosis (S3). According to VCTE measurements, 176 (57.14%) patients had liver fibrosis, 36 (11.7%) of them had advanced fibrosis (F3), and 42 (13.6%) diabetic patients had cirrhosis (F4). Univariate analyses showed that severe steatosis was significantly associated with ferritin (beta = 0.223, p = 0.022), total cholesterol (beta = 0.159, p = 0.031), and HDL-cholesterol (beta = -0.120, p = 0.006). In multivariate analyses, BMI (beta = 0.349, p < 0.001), fasting plasma glucose (beta = 0.211, p = 0.006), and triglycerides (beta = 0.132, p = 0.044) were predictors of S3. Patients with T2DM have a high prevalence of severe steatosis and advanced fibrosis which can lead to the development and progression of complications with high morbidity and mortality rates. Hence, it is necessary to implement screening strategies to prevent advanced liver disease in patients with T2DM. FAU - Trifan, Anca AU - Trifan A AUID- ORCID: 0000-0001-9144-5520 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Stratina, Ermina AU - Stratina E AUID- ORCID: 0000-0002-8526-988X AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Nastasa, Robert AU - Nastasa R AUID- ORCID: 0000-0002-8678-0663 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Rotaru, Adrian AU - Rotaru A AUID- ORCID: 0000-0002-6459-6996 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Stafie, Remus AU - Stafie R AUID- ORCID: 0000-0003-1460-6559 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Zenovia, Sebastian AU - Zenovia S AUID- ORCID: 0000-0003-0441-3980 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Huiban, Laura AU - Huiban L AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Sfarti, Catalin AU - Sfarti C AUID- ORCID: 0000-0001-7074-5938 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Cojocariu, Camelia AU - Cojocariu C AUID- ORCID: 0000-0001-6395-335X AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Cuciureanu, Tudor AU - Cuciureanu T AUID- ORCID: 0000-0003-1550-8870 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Muzica, Cristina AU - Muzica C AUID- ORCID: 0000-0003-0891-5961 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Chiriac, Stefan AU - Chiriac S AUID- ORCID: 0000-0003-2497-9236 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Girleanu, Irina AU - Girleanu I AUID- ORCID: 0000-0001-5925-1232 AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Singeap, Ana-Maria AU - Singeap AM AUID- ORCID: 0000-0001-5621-548X AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. FAU - Stanciu, Carol AU - Stanciu C AD - Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania. AD - Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania. LA - eng PT - Journal Article DEP - 20220720 PL - Switzerland TA - Diagnostics (Basel) JT - Diagnostics (Basel, Switzerland) JID - 101658402 PMC - PMC9322355 OTO - NOTNLM OT - non-alcoholic fatty liver OT - type 2 diabetes mellitus OT - vibration-controlled transient elastography COIS- The authors declare no conflict of interest. EDAT- 2022/07/28 06:00 MHDA- 2022/07/28 06:01 PMCR- 2022/07/20 CRDT- 2022/07/27 01:16 PHST- 2022/06/02 00:00 [received] PHST- 2022/06/27 00:00 [revised] PHST- 2022/07/18 00:00 [accepted] PHST- 2022/07/27 01:16 [entrez] PHST- 2022/07/28 06:00 [pubmed] PHST- 2022/07/28 06:01 [medline] PHST- 2022/07/20 00:00 [pmc-release] AID - diagnostics12071753 [pii] AID - diagnostics-12-01753 [pii] AID - 10.3390/diagnostics12071753 [doi] PST - epublish SO - Diagnostics (Basel). 2022 Jul 20;12(7):1753. doi: 10.3390/diagnostics12071753.