Non-alcoholic fatty liver disease and type 2 diabetes mellitus: issues of the liver fibrosis diagnostics
- 作者: Anisonyan A.1, Sandler Y.1, Khaimenova T.1, Keyan V.1, Saliev K.1, Sbikina E.1, Vinnitskaya E.1
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隶属关系:
- Loginov Moscow Clinical Scientific and Practical Center
- 期: 卷 92, 编号 8 (2020)
- 页面: 73-78
- 栏目: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/43544
- DOI: https://doi.org/10.26442/00403660.2020.08.000770
- ID: 43544
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Aim. To evaluate the frequency of liver fibrosis progression to stage 3–4 among patients with non-alcoholic fatty liver disease (NAFLD), type 2 diabetes and obesity, to identify predictors of severe liver fibrosis, to propose an algorithm for diagnosing fibrosis in this category of patients.
Materials and methods. 160 patients with NAFLD, type 2 diabetes mellitus (DM) and obesity and 50 patients with NAFLD without diabetes were comprehensively examined. Patients underwent laboratory examination (clinical blood test, biochemical analysis, immunoglobulins G, M, autoantibody assay, coagulogram), liver ultrasound. All patients underwent determination of the liver fibrosis stage by two methods: the serological test FibroMax and indirect ultrasound elastometry of the liver; 40 patients underwent a liver biopsy. Statistical data processing was performed using the programming language and statistical calculations R: we used correlation analysis, multiple logistic regression method, one-way analysis of variance, multi-factor analysis, the Kruskal-Wallis method, and comparison of the number of patients using the Fisher test.
Results. DM is a risk factor for the liver fibrosis progression in patients with NAFLD. Significant markers of severe fibrosis in this category of patients are increased levels of GGTP, haptoglobin and alpha-2-macroglobulin, lower platelet and prothrombin levels. Obesity and isolated steatosis without steatohepatitis are not markers of severe liver fibrosis at present, but obesity can be considered a risk factor for the progression of fibrosis in the future.
Conclusion. All patients with NAFLD in combination with diabetes need screening to detect advanced liver fibrosis: it is advisable to determine the levels of GGTP, haptoglobin and alpha-2-macroglobulin.
作者简介
A. Anisonyan
Loginov Moscow Clinical Scientific and Practical Center
编辑信件的主要联系方式.
Email: anastasiya7651@yandex.ru
ORCID iD: 0000-0003-2869-0712
м.н.с. Центра диагностики заболеваний печени
俄罗斯联邦, MoscowYu. Sandler
Loginov Moscow Clinical Scientific and Practical Center
Email: anastasiya7651@yandex.ru
ORCID iD: 0000-0003-4291-812X
к.м.н., с.н.с. научно-исследовательского отд. гепатологии
俄罗斯联邦, MoscowT. Khaimenova
Loginov Moscow Clinical Scientific and Practical Center
Email: anastasiya7651@yandex.ru
ORCID iD: 0000-0002-4599-4040
к.м.н., зав. отд-нием заболеваний печени
俄罗斯联邦, MoscowV. Keyan
Loginov Moscow Clinical Scientific and Practical Center
Email: anastasiya7651@yandex.ru
ORCID iD: 0000-0001-7284-8842
н.с. отд. гепатологии
俄罗斯联邦, MoscowK. Saliev
Loginov Moscow Clinical Scientific and Practical Center
Email: anastasiya7651@yandex.ru
ORCID iD: 0000-0002-4581-7052
м.н.с. отд. гепатологии
俄罗斯联邦, MoscowE. Sbikina
Loginov Moscow Clinical Scientific and Practical Center
Email: anastasiya7651@yandex.ru
ORCID iD: 0000-0003-2195-9643
м.н.с. научно-исследовательского отд. гепатологии
俄罗斯联邦, MoscowE. Vinnitskaya
Loginov Moscow Clinical Scientific and Practical Center
Email: anastasiya7651@yandex.ru
ORCID iD: 0000-0002-0344-8375
д.м.н., зав. отд. гепатологии
俄罗斯联邦, Moscow参考
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