ECE2019 Poster Presentations Diabetes, Obesity and Metabolism 3 (112 abstracts)
1Service for Endocrinology, Diabetology and Metabolic Diseases, Casablanca, Morocco; 2Hepatology-Gastrology-Enterology Service, Casablanca, Morocco.
Introduction: Metabolic steatopathy is frequently associated with type 2 diabetes, which may progress to advanced fibrosis. The objectives of this study were to evaluate the prevalence and predictors of the severity of hepatic impairment in this population.
Methods: A cross-sectional study involving 281 type 2 diabetic patients followed in the endocrinology department in collaboration with the Hepato-Gastroenterology department of Ibn Rochd University Hospital in Casablanca between January 2018 and September 2018. Severity of liver injury was evaluated by the Fib4 score calculated according to the following formula: age x AST (U/L)/Platelets (109/L) × ALT (U/L)½. A Fib4 score>3.25 is predicted advanced fibrosis. Statistical analysis was performed by SPSS 25.
Results: 281 diabetic patients were included, 215 women and 66 men. The mean age was 54.15±13.45 years old. 7% were smokers and only 1.4% of cases were ethyl (<20 g/d). The mean duration of diabetes progression was 10.5±8.5 years. A BMI ≥ 30 kg/m2 was found in 122 patients (43.4%). The ALT average was 22.01±18.59 IU/L and ASAT was 21.33±16.80 IU/L. Hypertriglyceridemia was found in 105 of patients (37.4%) and hypoHDLemia was found in 63 of patients(22.4%). The average Fib4 of the patients was 1.05±0.72. 227 (80.8%) patients had a Fib4 <1.45. 46 patients had Fib4 between 1.45 and 3.25, and 8 patients (2.8%) had an advanced fibrosis with Fib4> 3.25. In multivariate analysis, independent factors related to advanced liver fibrosis were the duration of diabetes (OR =1.60, P<0.01), elevated AST (OR =0.99, P<0.03), hypoHDLemia (OR =1.53, P<0.001) and hypercholesterolemia (OR =1.32, P<0.05).
Conclusion: Advanced fibrosis was only found in 2.8% of non-alcoholic diabetics. The low rate of alcohol users could explain our results. Duration of diabetes progression, dyslipidemia and elevated AST levels were predictive factors for advanced fibrosis.