Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease: the Facets of Conjugacy

Abstract

The purpose of the study. To assess the incidence of steatosis (SP) and liver fibrosis (AF) in patients with diabetes mellitus (DM) using non-invasive methods of liver fibroelastometry (FEP) and fibrotest panel (FT); to determine their diagnostic significance and identify factors affecting the development of AF.

Materials and methods. 82 patients with DM were comprehensively examined (mean age 56.7±12.7 years; p=0.033). Statistical evaluation of the data was carried out using ROC analysis, correlation and one-factor analysis of variance, multiple logistic regression.

Results. Among patients with DM, according to FT and FEP, liver cirrhosis was detected in 12 (14.6%) and 15 (18.2%), respectively CPU (F4 on the METAVIR scale). Clinically significant stage of fibrosis (F2—3) was determined in 19 (23.1%) by FT and in 23 (28%) by FEP. SP of varying degrees was present in 79 (96.3%). FEP and FT show comparable results in the detection of cirrhosis of the liver (AUROC: 0.83 and 0.81). The development of AF is influenced by factors such as the level of SP, obesity, the activity of the inflammatory process, the level of alanine aminotransferase, a2 - macroglobulin.

Conclusion. Patients with DM have a high risk of developing NAFLD with the formation of AF and CP. FEP and FT have shown comparably high reliability in the diagnosis of CP in patients with DM and can be used for screening examination. Taking into account the existing risk factors for the development of AF and CP, it is necessary to identify groups of patients with DM for further examination and follow-up. Patients who have been diagnosed with stage F4 should be thoroughly examined to assess competing diseases and perform a liver biopsy.