AUTHOR=SANCHEZ BAO ANA MARIA 

TITLE=Identifying advanced MAFLD in a cohort of T2DM and clinical features

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1058995

DOI=10.3389/fendo.2023.1058995

ISSN=1664-2392

ABSTRACT=Background: MAFLD is the most common cause of chronic liver disease, affecting 25% of the global population. Patients with T2DM have an increased risk of developing MAFLD. In addition, patients with T2DM have a higher risk of advanced forms of steatohepatitis and fibrosis. Identifying those patients is critical in order to refer them to specialist and appropriate management of their disease.

Aims and Objectives: To report advanced fibrosis prevalence in a cohort of patients with T2DM and to identify patients at risk. 


Results: 96 patients (21%) presented risk of  significant fibrosis (F2) measured by TE and  45 patients (10%) presented with risk of  advanced fibrosis F3-F4. Liver fibrosis was related to BMI, AC, HOMA2-IR.  The results of the non-invasive fibrosis scores have been validated with the results obtained in the TE. It is observed that the index with the greatest area under the curve (AUC) is APRI (AUC=0.729), with a sensitivity of 62.2% and a specificity of 76.1% (Figure 1). However the test with better positive likelihood ratio (LHR+) in our study is NAFLD fibrosis score 
Conclusions: Our results show that in a general T2DM follow up, 10% of patients were at risk of advanced fibrosis. We found a positive correlation between liver fibrosis and  BMI, AC and HOMA2-IR. Non-invasive fibrosis markers can be useful for screening, showing NAFLD Fibrosis score a better LHR+ compared to TE. Further studies are needed to validate these results and elucidate the best screening approach to identify those patients at risk of advanced MAFLD.