University Hospital in Brussels, Belgium
M Aerts is currently working at the University Hospital in Brussels, UZ-Brussel. She is a staff member of the Gastroenterology/Hepatology Department since 2012.
Background: NAFLD is a multifactorial disease with an enormous increase in prevalence worldwide. It is known that patients with diabetes mellitus type 2 (DMT2) are at higher risk of developing NAFLD and are more likely to progress to more severe disease.
Methods: Patients with DMT2 presenting at the diabetes liver clinic were evaluated with abdominal ultrasound (US). If steatosis was present, they underwent a Fibroscan® or elastography (ARFI) and a blood test. Risk scores, (NAFLD fibrosis score and Antwerp NASH score) were calculated to estimate the presence of NASH and/or advanced fibrosis.
Results: 112 patients underwent US, of which 90 (55 male, 35 female) had steatosis (80%). Mean age was 57.2 yrs (range 40 - 78). All patients with steatosis on US underwent Fibroscan® (11) or elastography (75) or both (4). 22 patients (24%) had ≥F2 fibrosis (Fibroscan® > 7.2 kPa or elastography >1.32m/s). 7 patients (8%) had F4 fibrosis, (Fibroscan® >14.5 kPa, or ARFI>1.87. The NAFLD fibrosis score was calculated in 90 patients. In 19 patients (21%) the NAFLD fibrosis score was > 0.676, suggestive for ≥F3 fibrosis; only in 10 patients (11%) the score was < -1.455, excluding significant fibrosis. The remainder (68%) had an intermediate score. The Antwerp NASH score was calculated in 86 patients. In 31 patients (36%) the score was > 1.34,
suggestive for NASH; in 9 patients (10.5%) this score was < -1.34, excluding NASH.
Conclusions: Our results confirm that NAFLD is very common in DMT2 patients. Moreover, many patients are at risk for developing NASH and/or advanced fibrosis. These patients should be followed-up closely to detect complications early. Awareness of this progressive disease among diabetologists and hepatologists is vital to identify patients who need close followup and hopefully specific treatment in the near future.