Feasibility and efficiency of European guidelines for NAFLD assessment in patients with type 2 diabetes : A prospective study
Copyright © 2021 Elsevier B.V. All rights reserved..
AIM: We aimed to evaluate the feasibility and efficiency of a guidelines-compliant NAFLD assessment algorithm in patients with newly diagnosed type 2 diabetes (T2D).
METHODS: Consecutive patients aged < 75 newly diagnosed with T2D without coexisting liver disease or excessive alcohol consumption were enrolled. Patients were stratified based on liver enzymes, fatty liver index, ultrasound, fibrosis scores and liver stiffness measurement. Referral rates and positive predictive values (PPVs) for histological non-alcoholic steatohepatitis (NASH) and significant fibrosis were evaluated.
RESULTS: Of the 171 enrolled patients (age 59 ± 10.2 years, 42.1% females), 115 (67.3%) were referred to a hepatologist due to abnormal liver enzymes (n = 60) or steatosis plus indeterminate (n = 37) or high NAFLD fibrosis score (n = 18). Liver biopsy was proposed to 30 patients (17.5%), but only 14 accepted, resulting in 12 NASH, one with significant fibrosis. The PPV of hepatological referral was 12/76 (15.8%) for NASH and 1/76 (1.3%) for NASH with significant fibrosis. The PPV of liver biopsy referral was 12/14 (85.7%) for NASH and 1/14 (7.1%) for NASH with significant fibrosis.
CONCLUSIONS: By applying a guidelines-compliant algorithm, many patients with T2D were referred for hepatological assessment and liver biopsy. Further studies are necessary to refine non-invasive algorithms.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:177 |
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| Enthalten in: |
Diabetes research and clinical practice - 177(2021) vom: 01. Juli, Seite 108882 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Besutti, Giulia [VerfasserIn] |
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| Links: |
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| Themen: |
Hepatocellular carcinoma |
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| Anmerkungen: |
Date Completed 06.10.2021 Date Revised 06.10.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.diabres.2021.108882 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM326304118 |
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| 100 | 1 | |a Besutti, Giulia |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Feasibility and efficiency of European guidelines for NAFLD assessment in patients with type 2 diabetes |b A prospective study |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 06.10.2021 | ||
| 500 | |a Date Revised 06.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier B.V. All rights reserved. | ||
| 520 | |a AIM: We aimed to evaluate the feasibility and efficiency of a guidelines-compliant NAFLD assessment algorithm in patients with newly diagnosed type 2 diabetes (T2D) | ||
| 520 | |a METHODS: Consecutive patients aged < 75 newly diagnosed with T2D without coexisting liver disease or excessive alcohol consumption were enrolled. Patients were stratified based on liver enzymes, fatty liver index, ultrasound, fibrosis scores and liver stiffness measurement. Referral rates and positive predictive values (PPVs) for histological non-alcoholic steatohepatitis (NASH) and significant fibrosis were evaluated | ||
| 520 | |a RESULTS: Of the 171 enrolled patients (age 59 ± 10.2 years, 42.1% females), 115 (67.3%) were referred to a hepatologist due to abnormal liver enzymes (n = 60) or steatosis plus indeterminate (n = 37) or high NAFLD fibrosis score (n = 18). Liver biopsy was proposed to 30 patients (17.5%), but only 14 accepted, resulting in 12 NASH, one with significant fibrosis. The PPV of hepatological referral was 12/76 (15.8%) for NASH and 1/76 (1.3%) for NASH with significant fibrosis. The PPV of liver biopsy referral was 12/14 (85.7%) for NASH and 1/14 (7.1%) for NASH with significant fibrosis | ||
| 520 | |a CONCLUSIONS: By applying a guidelines-compliant algorithm, many patients with T2D were referred for hepatological assessment and liver biopsy. Further studies are necessary to refine non-invasive algorithms | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Hepatocellular carcinoma | |
| 650 | 4 | |a Liver biopsy | |
| 650 | 4 | |a Liver fibrosis | |
| 650 | 4 | |a Non-alcoholic fatty liver disease | |
| 650 | 4 | |a Non-alcoholic steatohepatitis | |
| 650 | 4 | |a Type 2 diabetes mellitus | |
| 700 | 1 | |a Bonilauri, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Manicardi, Elisa |e verfasserin |4 aut | |
| 700 | 1 | |a Venturelli, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Bonelli, Efrem |e verfasserin |4 aut | |
| 700 | 1 | |a Monelli, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Manicardi, Valeria |e verfasserin |4 aut | |
| 700 | 1 | |a Valenti, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Ligabue, Guido |e verfasserin |4 aut | |
| 700 | 1 | |a Schianchi, Susanna |e verfasserin |4 aut | |
| 700 | 1 | |a Massari, Marco |e verfasserin |4 aut | |
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| 700 | 1 | |a Tagliavini, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Pattacini, Pierpaolo |e verfasserin |4 aut | |
| 700 | 1 | |a Giorgi Rossi, Paolo |e verfasserin |4 aut | |
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