Lipids & metabolic liver disease
High Prevalence of Nonalcoholic Steatohepatitis (NASH) and Advanced Fibrosis in Type 2 Diabetes: A Prospective Study of 330 Outpatients Undergoing Liver Biopsies for Elevated ALT, Using a Low Threshold
Authors' conclusion
Despite the use of a low ALT threshold, prevalence of NASH (58%) or AF (38%) was high. Routinely available data had a high yield in identifying patients with T2DM with AF and/or NASH requiring further liver assessment.
Study context
- Population
- Outpatients with T2D screened for NAFLD per ADA criteria in four diabetology clinics, referred to hepatologists; liver biopsy proposed for ALT persistently >20 IU/L (women) or >30 IU/L (men) without other liver disease; median age 59 years, 63% male, median BMI 32, median HbA1c 7.5%330 adequate biopsies
- Participants
- 713 outpatients
- Outcome
- Prevalence on liver biopsy
Methodological detailsmulticenter, Liver biopsies performed in 360 patients; 330 adequate after central review
- Multicenter
- Liver biopsies performed in 360 patients; 330 adequate after central review
Main finding
As reported in the abstract
NASH prevalence
58%
Advanced fibrosis prevalence
38%
Cirrhosis prevalence
10%
Observational data: associations, not effects.
Further findings
Associations of liver lesions
- Liver lesions independently associated with metabolic syndrome components but not with micro- and macrovascular complications of T2D
Prediction of advanced fibrosis by models on routine data with or without VCTE
- AUROC with VCTE
- 0.84
- AUROC without VCTE
- 0.77
- Correctly classified with VCTE
- 59%
- Correctly classified without VCTE
- 45%
Prediction of NASH by models on routine data with or without VCTE
- AUROC with VCTE
- 0.82
- AUROC without VCTE
- 0.81
- Correctly classified with VCTE
- 44%
- Correctly classified without VCTE
- 42%
Original publication
High Prevalence of NASH and Advanced Fibrosis in Type 2 Diabetes: A Prospective Study of 330 Outpatients Undergoing Liver Biopsies for Elevated ALT, Using a Low Threshold. Diabetes Care. Published 12 April 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →