PMID- 38206118 OWN - NLM STAT- MEDLINE DCOM- 20240214 LR - 20240409 IS - 2050-6414 (Electronic) IS - 2050-6406 (Print) IS - 2050-6406 (Linking) VI - 12 IP - 1 DP - 2024 Feb TI - Obesity and harmful alcohol consumption are predictors for advanced liver disease in the disease management program for type 2 diabetes. PG - 11-21 LID - 10.1002/ueg2.12511 [doi] AB - BACKGROUND: Type 2 diabetes mellitus (T2DM) is a major risk factor for advanced liver disease. The aim of this prospective cohort study was to assess the prevalence and associated risk factors of liver fibrosis and cirrhosis in primary care centers participating in the diabetes disease management program (DMP) in Germany. METHODS: A total of 175 participants with the diagnosis of T2DM were enrolled in two primary care centers. Steatotic liver disease (SLD; hepatic steatosis, >/=275 dB/m), fibrosis (>/=8 kPa), and cirrhosis (>/=15 kPa) were assessed non-invasively using vibration-controlled transient elastography. Multivariable logistic regression analysis was performed to identify clinical predictors of fibrosis and cirrhosis. The AUDIT questionnaire was used to screen for alcohol consumption, and a score >/=8 was considered harmful alcohol consumption. RESULTS: The majority of participants were male (62%), and the median age was 66 years (interquartile range 59; 71). The median body mass index was 31.1 kg/m(2) , with 58.9% of the participants being obese. Harmful alcohol consumption was prevalent in 8.0% and 20.0% of the entire cohort and in those with cirrhosis, respectively. The prevalence of SLD, fibrosis, and cirrhosis was 77.1%, 42.3%, and 12.0%, respectively. In multivariable logistic regression analysis, obesity, and harmful alcohol consumption were associated with the highest odds of fibrosis (odds ratio [OR] 5.198, 95% confidence interval [CI] 2.269-11.908) and cirrhosis (OR 5.615, 95% CI 1.274-24.756), respectively. CONCLUSION: The prevalence of fibrosis and cirrhosis in patients seen in the diabetes DMP in Germany is high. Obesity and harmful alcohol consumption increase the risk of fibrosis and cirrhosis in people with T2DM. Screening for advanced liver disease and associated risk factors within the DMP program may reduce the liver disease burden in this high-risk population. CI - (c) 2024 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology. FAU - Michel, Maurice AU - Michel M AUID- ORCID: 0000-0001-7424-9085 AD - Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. AD - I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. FAU - Doll, Michelle AU - Doll M AD - Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. AD - I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. FAU - Albert, Nastasia AU - Albert N AD - Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. AD - I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. FAU - Morgenstern, Marc AU - Morgenstern M AD - Diabetology Practice Mainz, Mainz, Germany. FAU - Behr, Andreas AU - Behr A AD - Diabetology and Family Practice, Bad Kreuznach, Germany. FAU - Maxeiner, Stefan AU - Maxeiner S AD - Diabetology and Family Practice, Bad Kreuznach, Germany. FAU - Labenz, Christian AU - Labenz C AUID- ORCID: 0000-0001-8390-9663 AD - Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. AD - I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. FAU - Galle, Peter R AU - Galle PR AD - Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. AD - I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. FAU - Schattenberg, Jorn M AU - Schattenberg JM AUID- ORCID: 0000-0002-4224-4703 AD - Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. AD - I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. AD - Department of Internal Medicine II, Saarland University Medical Centre, Homburg, Germany. AD - University of the Saarland, Saarbrucken, Germany. LA - eng PT - Journal Article DEP - 20240111 PL - England TA - United European Gastroenterol J JT - United European gastroenterology journal JID - 101606807 SB - IM MH - Humans MH - Male MH - Female MH - Aged MH - *Diabetes Mellitus, Type 2/diagnosis/epidemiology MH - Prospective Studies MH - Liver Cirrhosis/diagnosis/epidemiology/etiology MH - Obesity/complications/diagnosis/epidemiology MH - Alcohol Drinking/adverse effects/epidemiology MH - *Alcoholism/complications MH - Disease Management PMC - PMC10859704 OTO - NOTNLM OT - VCTE OT - alcohol consumption OT - cirrhosis OT - liver fibrosis OT - obesity OT - steatotic liver disease OT - type 2 diabetes COIS- JMS reports Consultants: Apollo Endosurgery, Albireo Pharma Inc, Bayer, BMS, Boehringer Ingelheim, Echosens, Genfit, Gilead Sciences, GSK, Heel GmbH, Intercept Pharmaceuticals, Ipsen, Inventiva Pharma, Madrigal, MSD, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi, Siemens Healthcare GmbH. Research Funding: Gilead Sciences, Boehringer Ingelheim, Nordic Bioscience, Siemens Healthcare GmbH. Speaker Honorarium: MedPublico GmbH, Boehringer Ingelheim, Madrigal, Novo Nordisk; Stock Holder: AGED diagnostics, Hepta Bio. The other authors declare that they have no competing interests. EDAT- 2024/01/11 12:43 MHDA- 2024/02/12 15:42 PMCR- 2024/01/11 CRDT- 2024/01/11 09:52 PHST- 2023/07/05 00:00 [received] PHST- 2023/11/07 00:00 [accepted] PHST- 2024/02/12 15:42 [medline] PHST- 2024/01/11 12:43 [pubmed] PHST- 2024/01/11 09:52 [entrez] PHST- 2024/01/11 00:00 [pmc-release] AID - UEG212511 [pii] AID - 10.1002/ueg2.12511 [doi] PST - ppublish SO - United European Gastroenterol J. 2024 Feb;12(1):11-21. doi: 10.1002/ueg2.12511. Epub 2024 Jan 11.