Screening for liver fibrosis by using FibroScan® and FibroTest in patients with diabetes

Background: Patients with diabetes are at risk for nonalcoholic fatty liver disease leading to cirrhosis. Existing guidelines do not advocate screening for liver related complications amongst persons with diabetes. Aim: The aim of this prospective study was to identify patients with severe liver fibrosis amongst patients hospitalized for their diabetes, using non-invasive methods, and to evaluate factors associated with severe fibrosis. Methods: Consecutive patients with type 1 or 2 diabetes had clinical, biological parameters and liver fibrosis evaluation. Severe fibrosis was predicted when FibroTest was > 0.59 or liver stiffness > 8.7 kPa. Results: A total of 277 patients were evaluated (type 1 diabetes 52%). The prevalence of severe fibrosis was 15.5%. By univariate analysis, factors associated with severe fibrosis were age, type 2 diabetes, body mass index, metabolic syndrome, previous cardiovascular events, no retinopathy, past history of foot ulcer, and elevated alanine aminotransferase. By multivariate analysis, factors associated with severe fibrosis were age > 50 years, type 2 diabetes, no retinopathy, and past history of foot ulcer. Conclusion: This study showed an elevated prevalence of severe fibrosis in hospitalized diabetic patients, especially patients aged 50 years or older with type 2 diabetes, or with a past history of foot ulcer. (C) 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.