ISSN: 1859 - 2872
Study on factors associated with steatosis and liver fibrosis in type 2 diabetes patients
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Abstract
Objective: To evaluate the relationship between the degree of steatosis and liver fibrosis with hepatitis B and hepatitis C virus infection, alcohol consumption in patients with type 2 diabetes had metabolic dysfunction-associated fatty liver disease (MAFLD). Subject and method: A descriptive, cross-sectional study was conducted on 163 patients with type 2 diabetes who were examined and treated at 175 Military Hospital from August 2022 to April 2023. The study utilized Fibroscan to determine the degree of steatosis and liver fibrosis then compare some clinical and subclinical features in the group of patients with MAFLD and without MAFLD as well as between MAFLD alone and MAFLD with HBV and HCV infection, with or without alcohol consumption. Result: The prevalence of MAFLD in patients with type 2 diabetes was 66.3%. The degrees of liver steatosis were categorized as S1 (20.4%), S2 (23.1%), and S3 (56.5%), while the levels of liver fibrosis were F0-F1 (53.7%), F2 (20%), and F3-F4 (27.8%). Additionally, 39.8% of patients with MAFLD also reported alcohol consumption, 30.6% were infected with HBV, and 8.3% were infected with HCV. The MAFLD group did not show significant differences in age, medical history, rate of alcohol consumption, HBV and HCV infection, and levels of cholesterol, LDL-C, AST, ALT, GGT but had BMI and triglyceride concentration were higher than the group without MAFLD. The MAFLD group had a higher degree of liver steatosis, but lower levels of liver fibrosis compared to the MAFLD group with HBV and HCV infection or alcohol consumption, this difference was found to be statistically significant. Conclusion: Patients with type 2 diabetes often had a significant presence of MAFLD, characterized by severe liver steatosis and mild liver fibrosis. In addition to metabolic disorders, secondary causes such as HBV infection, alcohol use, and HCV infection were also common contributors to hepatic steatosis in MAFLD patients. The MAFLD group had a significantly higher BMI and triglyceride concentration than the group without MAFLD. The MAFLD group showed higher degree of liver steatosis and lower level of liver fibrosis compared to the MAFLD group with coexisting HBV and HCV infections or alcohol consumption.
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2. de Lédinghen V, Wong GL, Vergniol J, Chan HL, Hiriart JB, Chan AW, Chermak F, Choi PC, Foucher J, Chan CK, Merrouche W, Chim AM, Le Bail B, Wong VW (2016) Controlled attenuation parameter for the diagnosis of steatosis in non-alcoholic fatty liver disease. J Gastroenterol Hepatol 31(4): 848-855.
3. Eslam M, Newsome PN, Sarin SK et al (2020) A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol 73(1): 202-209.
4. Frulio N, Trillaud H (2013) Ultrasound elastography in liver. Diagn Interv Imaging 94(5): 515-534.
5. Guan C, Fu S, Zhen D, Yang K, An J, Wang Y, Ma C, Jiang N, Zhao N, Liu J, Yang F, Tang X (2022) Metabolic (Dysfunction)-associated fatty liver disease in chinese patients with type 2 diabetes from a subcenter of the national metabolic management center. J Diabetes Res, 8429847.
6. Kawaguchi T, Tsutsumi T, Nakano D, Eslam M, George J, Torimura T (2022) MAFLD enhances clinical practice for liver disease in the Asia-Pacific region. Clin Mol Hepatol 28(2): 150-163.
7. Kim H, Lee DS, An TH, Park HJ, Kim WK, Bae KH, Oh KJ (2021) Metabolic spectrum of liver failure in type 2 diabetes and obesity: From NAFLD to NASH to HCC. Int J Mol Sci 22(9).
8. Lv H, Jiang Y, Zhu G, Liu S, Wang D, Wang J, Zhao K, Liu J (2023) Liver fibrosis is closely related to metabolic factors in metabolic associated fatty liver disease with hepatitis B virus infection. Scientific Reports 13(1): 1388.
9. Mikolasevic I, Orlic L, Franjic N, Hauser G, Stimac D, Milic S (2016) Transient elastography (FibroScan(®)) with controlled attenuation parameter in the assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease - Where do we stand?. World J Gastroenterol 22(32): 7236-7251.
10. Powell EE, Wong VW, Rinella M (2021) Non-alcoholic fatty liver disease. Lancet 397(10290): 2212-2224.
11. Tsai PS, Cheng YM, Wang CC, Kao JH (2023) The impact of concomitant hepatitis C virus infection on liver and cardiovascular risks in patients with metabolic-associated fatty liver disease. Eur J Gastroenterol Hepatol 35(11): 1278-1283.
12. Tuong TTK, Tran DK, Phu PQT, Hong TND, Dinh TC, Chu DT (2020) Non-alcoholic fatty liver disease in patients with type 2 diabetes: Evaluation of hepatic fibrosis and steatosis using fibroscan. Diagnostics (Basel), 10(3).
13. Wong GL (2013) Update of liver fibrosis and steatosis with transient elastography (Fibroscan). Gastroenterol Rep (Oxf) 1(1): 19-26.
14. Zhang J, Ling N, Lei Y, Peng M, Hu P, Chen M (2021) Multifaceted interaction between hepatitis B virus infection and lipid metabolism in hepatocytes: A potential target of antiviral therapy for chronic Hepatitis B. Front Microbiol 12: 636897.
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