Endocrine Abstracts

Background and aims: Non-alcohol fatty liver disease (NAFLD) is increasingly recognised in diabetic patients with metabolic syndrome. Patients with poorly-controlled diabetes and metabolic syndrome are likely to have significant liver inflammation leading to fibrosis. NAFLD fibrosis score (NFS) is a validated non-invasive scoring system that identifies liver fibrosis in patients with NAFLD. The aim of this study is to examine the glycaemic control in patients with or without significant hepatic fibrosis as assessed by NFS in routine clinic.

Methods: All patients with type 2 diabetes or impaired glucose tolerance/fasting glucose, attending the diabetic clinic from March to June 2014 were included retrospectively. Patients with type 1 diabetes and gestational diabetes were excluded. Data were obtained from laboratory database and electronic patient record (Cellma). NFS was calculated for each patient based on age, BMI, diabetes, AST/ALT, platelet, and albumin.

Results: 521 patients were screened and only 29.4% (153) of patients with complete laboratory data were studied. In our cohort of 153 patients, 64.1% (98) of patients were male and the median age was 63 (IQR 56.0–71.5) years. Using the NAFLD fibrosis score, almost a quarter of our patients (24.2%, n=37) had significant fibrosis with a median score of 1.169 (0.898–1.563) while the rest of the patients were indeterminate (66.0%, n=101) or had no significant fibrosis (9.8%, n=15). The median BMI for patients with significant hepatic fibrosis was 30.0 (27.8–34.5) kg/m² while for patients without significant fibrosis (including indeterminate score based on NFS), the median BMI was 34.8 (30.3–43.2) kg/m² (P<0.01). Interestingly, there were no significant differences in the mean HbA1c readings in patients with or without significant hepatic fibrosis (55.2±15.3 mmol/mol vs 56.6±17.9 mmol/mol; P=0.639).

Conclusion: In conclusion, we did not observe any significant differences in glycaemic control in patients with or without significant hepatic fibrosis, as assessed by NAFLD fibrosis score.