Liver Stiffness and Fibrosis Linked to T2DM in MASLD Study

핵심 개념

Liver stiffness and severe fibrosis are independently associated with type 2 diabetes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).

초록

TOPLINE:

• Liver stiffness and severe fibrosis, as measured by FibroScan, are linked to T2DM in MASLD patients.

METHODOLOGY:

• Data from clinical tests, FibroScan, and liver ultrasonography for 154 MASLD patients in China were analyzed.
• Specific focus on hepatic fibrosis and steatosis using FibroScan.
• Vascular complications and T2DM status data were collected.

TAKEAWAY:

• Hemoglobin A1c, insulin resistance index, gamma-glutamyl transferase, fibrosis indices, and liver stiffness were higher in MASLD patients with T2DM.
• Patients with MASLD and T2DM had lower serum uric acid levels.
• Severe fibrosis in MASLD patients had a higher frequency of T2DM.
• Liver stiffness and MetS were independent risk factors for incident T2DM in MASLD patients.

IN PRACTICE:

• Liver fibrosis screenings recommended for MASLD patients, especially those with MetS.
• Liver stiffness measurement can monitor fibrosis grade in relation to insulin resistance and T2DM emergence.

SOURCE:

• Study conducted by Shihai Xia and colleagues, published in Diabetes, Metabolic Syndrome and Obesity.

LIMITATIONS:

• Small sample size, older participants, and lack of follow-up data on liver stiffness and T2DM changes.

DISCLOSURES:

• Study funded by Logistics University of PAP and Characteristic Medical Center of the Chinese People's Armed Police Force.

통계

Patients with MASLD and T2DM had lower serum uric acid levels than those with MASLD alone (324.32 ± 90.94 mol/L vs 382.69 ± 98.84 mol/L).
Patients with severe fibrosis (79.3%) in the MASLD group had a greater frequency of T2DM than those with mild fibrosis (45.7%) or no fibrosis (27.8%).
Liver stiffness measurement and MetS were independent risk factors for incident T2DM among patients with MASLD (odds ratio, 1.466 and 0.273, respectively).

인용구

"Patients with [MASLD], especially those who have clinical indications of MetS, should have liver fibrosis screenings."
"Liver stiffness measurement can be used to dynamically monitor the grade of fibrosis in relation to [insulin resistance] and the emergence of T2DM during follow-up."

핵심 통찰 요약

Liver Stiffness, Fibrosis Tied to T2DM in MASLD

by Marilynn Lar... 게시일 www.medscape.com 02-07-2024

https://www.medscape.com/viewarticle/liver-stiffness-fibrosis-tied-t2dm-masld-2024a10002o7

더 깊은 질문

How can the findings of this study impact the screening and management of T2DM in MASLD patients?

The findings of this study suggest that liver stiffness and severe fibrosis, as measured by FibroScan, are independently linked to type 2 diabetes (T2DM) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This implies that screening for liver stiffness and fibrosis in MASLD patients, especially those with clinical indications of metabolic syndrome (MetS), can aid in the early detection and management of T2DM. By incorporating liver fibrosis screenings using tools like FibroScan, healthcare providers can dynamically monitor the progression of fibrosis in relation to insulin resistance and the emergence of T2DM during follow-up. This proactive approach can lead to timely interventions and personalized management strategies for T2DM in MASLD patients.

What potential biases could arise from the study's limitations, and how might they affect the validity of the results?

The study's limitations, such as a small sample size from a single institution and a preponderance of older participants with potentially higher rates of T2DM, could introduce biases that may impact the validity of the results. Selection bias may arise due to the limited sample size and the specific demographic characteristics of the participants, which may not be representative of the broader MASLD population. Additionally, the lack of follow-up data on liver stiffness and T2DM changes over time could lead to information bias, affecting the accuracy and reliability of the study findings. These limitations highlight the need for larger, more diverse studies with long-term follow-up to mitigate potential biases and enhance the generalizability of the results.

How can advancements in liver stiffness measurement technology further enhance the monitoring of fibrosis progression in patients with MASLD?

Advancements in liver stiffness measurement technology, such as FibroScan, offer non-invasive and accurate methods for monitoring fibrosis progression in patients with MASLD. These technological advancements enable healthcare providers to assess liver stiffness and fibrosis levels more precisely, allowing for early detection of liver damage and timely intervention. By utilizing advanced liver stiffness measurement tools, clinicians can track changes in fibrosis over time, tailor treatment plans based on individual risk profiles, and monitor the effectiveness of interventions. This personalized approach to monitoring fibrosis progression in MASLD patients can lead to improved patient outcomes, better management of liver-related complications, and enhanced overall care for individuals with MASLD and associated conditions like T2DM.