SFEBES2018 Poster Presentations Diabetes & cardiovascular (27 abstracts)
Assessment of liver imaging in a diabetic population with an abnormal AST-to-platelet-ratio-index (APRI) or Fibrosis-4-score (FIB4)
Stephen Ludgate 1 , Julie Steen 2 , Patrick Divilly 1 , Sara Naimimohasses 2 , Carmel Kennedy 1 , Agnieszka Pazderska 1 , Niamh Phelan 1 , Suzanne Norris 2 & Marie Louise Healy 1
1Department of Endocrinology, St James’s Hospital, Dublin, Ireland; 2Department of Hepatology, St James’s Hospital, Dublin, Ireland.
We conducted a retrospective study examining the prevalence of abnormal liver function tests (LFTs) in a diabetic population attending a tertiary referral centre and APRI and FIB4 scores were also calculated where possible. APRI and FIB4 scores can be used to estimate degree of liver fibrosis. APRI score >1 has 76% sensitivity, 72% specificity for predicting cirrhosis. APRI score >0.7 has 77% sensitivity, 72% specificity for predicting significant fibrosis. A FIB4 score >3.25 has 97% specificity and 65% positive predictive value for advanced fibrosis. However these have not been validated in a diabetic population. Of 1777 patients 600 (33.76%) had at least one abnormal LFT. APRI and FIB4 scores could not be calculated in 734 (41.31%). Of the remaining 1043 (58.69%), 31 (2.97%) had an APRI score >0.7, 18 (1.73%) ≥1. Of these 31, 22 had recent liver imaging performed. 3 (13.6%) of these were reported normal, 2 (9.1%) as mild fatty change and 17 (77.3%) as fibrotic change or cirrhosis. 265 (25.41%) had a FIB4 ≥1.45 and <3.25, and 18 (1.73%) ≥3.25. Of these 18 patients, 12 had recent liver imaging. 4 (33%) were reported normal, 1 (8.3%) showed metastases and 7 (58.3%) showed fibrosis or cirrhosis. This study shows that APRI may have a role in screening patients with diabetes for significant fibrosis or cirrhosis. However it does not indicate the aetiology of liver disease and so these results should be interpreted in correlation with a full clinical history and exam. Some studies also suggest that abnormal LFTs are a poor indicator for non-alcoholic steatohepatitis. For the 734 patients where APRI and FIB4 could not be calculated, this was due to a platelet count being unavailable and so a full blood count would be required to be added to routine diabetic bloods to utilise these scores.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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