Assessment of Hepatic Steatosis and Fibrosis in Egyptian Patients with Type 2 Diabetes Mellitus

Abstract

Aims: To assess hepatic steatosis and fibrosis in patients of type 2 diabetes mellitus (T2DM), their possible risk factors and their association with metabolic syndrome and micro or macro-albuminuria. Study Design: Cross sectional study. Place and Duration of Study: Outpatient Clinic of Diabetes, Metabolism and Endocrinology Unit in internal medicine department, Tanta University, Egypt in a period between September 2019 to March 2020. Methodology: We included 200 patients had a diagnosis of T2DM according to American Diabetes Association criteria. Then patients were assessed for presence of hepatic steatosis and fibrosis using fibroscan and we used liver stiffness measurements (LSMs, as a measure of fibrosis) and controlled attenuation parameter (CAP, as a measure of steatosis) and routine laboratory data were done to rule out possible risk factors. Results: 98.5% of participants had hepatic steatosis and 53.5% of participants had hepatic fibrosis. Those patients had longer duration of DM, higher BMI, bad control of T2DM, higher lipid profile values, association with metabolic syndrome, micro and macro-albuminuria and non-significantly elevated liver enzymes. Conclusion: Hepatic steatosis and fibrosis are highly prevalent in patients with T2DM, incidence of hepatic steatosis and fibrosis is positively correlated with longer duration of DM, higher BMI, bad control of DM, dyslipidemia, presence of metabolic syndrome, diabetic nephropathy, weakly correlated with liver enzymes. TE is an accurate and non-invasive tool to be used in screening for hepatic steatosis and fibrosis ,so we recommend screening for hepatic steatosis and fibrosis using fibroscan to help in early management and prevent its progression into liver cirrhosis.