• Stephen P Casey, William W Kemp, Catriona A McLean, Duncan J Topliss, Leon A Adams, and Stuart K Roberts.
• Departments of Gastroenterology, Alfred Hospital, Melbourne, Vic, Australia.
• Scand. J. Gastroenterol. 2012 Jul 1; 47 (7): 836-41.

BackgroundType 2 diabetes mellitus (T2DM) is a major risk factor for the development of non-alcoholic fatty liver disease (NAFLD) and subsequently hepatic fibrosis. Transient elastography (TE) is a rapid, reproducible non-invasive test that may be appropriate as a screening tool for the presence of hepatic fibrosis.AimAssess the utility of TE as a screening tool for the presence of hepatic fibrosis in a T2DM population with no known liver disease.MethodsT2DM patients without known liver disease were included. Patients were assessed with TE in addition to biochemical parameters.ResultsA successful TE evaluation could be obtained in 74 of 81 (91%) included subjects. Of these, 26 (35%) had a liver stiffness measurement (LSM) ≥ 7.65 kPa. Sixteen of these subjects had confirmatory liver biopsies with significant (≥ F2 fibrosis) present in 12 (75%) and cirrhosis diagnosed in 2 subjects. 15/16 (94%) had histological steatohepatitis. Compared with those with a lower LSM, subjects with an LSM ≥ 7.65 kPa had higher ALT levels (38.0 ± 21.7 vs 26.1 ± 11.1 U/L, p = 0.021) and increased prevalence of hepatic steatosis by ultrasound (85% vs 63%, p = 0.005).ConclusionSignificant hepatic fibrosis in the T2DM population is frequently under-recognized. TE may be a feasible tool for the screening of T2DM patients for the presence of hepatic fibrosis.

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