Enfermedad hepática grasa no alcohólica avanzada enpacientes con diabetes mellitus tipo 2

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease, affecting a quarter of the world's adult population. NAFLD is closely related to type 2 diabetes mellitus (T2DM), obesity and metabolic syndrome. The evolution of the pathology is still uncertain, but it is known that the presence of fibrosis is the main predictor of disease progression, complications, and mortality, therefore identifying the presence of advanced fibrosis is of vital importance. Objective: to estimate the prevalence of advanced NASH in a population with DM2 and to define its phenotypic characteristics. Material and methods: the data of 577 patients with T2DM who successively attended consultations for their routine check-up were analyzed. The sample studied included 265 (45.8%) men and 312 (54.2%) women, with a mean age of 65.4 } 7.8 years, a mean BMI of 31.50 } 5.36 Kg/ m2 and a T2DM evolution time of 12.9 } 8.56 years. Subjects were clinically evaluated, 4 indirect fibrosis test were performed (APRI, NAFLD Fibrosis Score, FIB-4, Hepamet Fibrosis Score) and transient hepatic elastography through FibroscanÒ with M and XL probe. A statistical analysis of the available data was performed with SPSS R version 22. Results: a prevalence of NAFLD with advanced fibrosis (³ F3) of 10% was observed. A statistically significant association was observed between advanced fibrosis and insulin resistance (IR) values measured by HOMA2-IR as well as with the degree of BMI and AC. No statistically significant association was found with the time of evolution of T2DM or with the degree of control. Conclusions: a significant proportion of patients with T2DM may present fibrosis in advanced stages (³ F3). The degree of IR, the BMI and the PC could be predictors of risk.