Endocrine Abstracts

Objective: Higher obesity rates are related with increased non-alcoholic fatty liver disease (NAFLD) prevalence which may progress further to non-alcoholic steatohepatitis (NASH) and cirrhosis. The utility of Fibroscan was shown in stratifying risk for significant liver disease. The aim of the study was to evaluate the relation between body mass index (BMI) and liver stiffness measurements (LSM) in overweight and obese patients.

Methods: We conducted the study in 369 (145 men, 224 women) patients aged between 18-75 years old and body mass index over 25 kg/m²from department of endocrinology and metabolism disease and gastroenterology, School of Medicine, Recep Tayyip Erdogan University. We performed a fibroscan assessment and collected biochemical, demographic, and clinical data. Patients were categorized as group I with mild/moderate fibrosis (MF) (F0- F2) and group II with advanced fibrosis (AF) (F3-F4).

Results: Overall, 42.8% of patients had liver fibrosis. Among these, 56 patients had AF whereas 102 patients had MF. Mean BMI was 36.46±7.77 in group 1 vs 34.59±6.27 in group 2 (P:0.04). Type 2 diabetes was seen in 54.7% of patients in group 1 vs 70.2% of patients in group 2 (P:0.03). In binary logistic regression analysis, there was a negative association between BMI and LSM (OR: 0.409, 95% CI 0.202-0.827) whereas a positive association was found with presence of type 2 diabetes (OR: 2.495, 95% CI 1.203-5.176), (P:0.006).

Conclusion: The study showed that presence of type 2 diabetes is a strong predictor of advanced liver fibrosis, and physicians should suspect diagnosis even in lower BMI values particularly in patients with diabetes.

Reference: 1. Moran-Lev H, Cohen S, Webb M, et al. Higher BMI predicts liver fibrosis among obese children and adolescents with NAFLD - an interventional pilot study. BMC Pediatr. 2021;21(1):385.2. Xia, Ming-Feng et al. ‘;NAFLD and Diabetes: Two Sides of the Same Coin? Rationale for Gene-Based Personalized NAFLD Treatment.’; Frontiers in pharmacology, 20193. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology 77(5):p 1797-1835, May 2023.