The risk of liver disease in patients with type 2 diabetes needs to be taken seriously: A real-world study located in a new community-based liver scanning service

Reinson, Tina, Patel, Janisha, Mathews, Mead and Byrne, Christopher (2022) The risk of liver disease in patients with type 2 diabetes needs to be taken seriously: A real-world study located in a new community-based liver scanning service. Diabetes UK Professional Conference 2022, QEII Centre, London, United Kingdom. 29 Mar - 01 Apr 2022. 29 pp . (doi:10.1111/dme.14809).

Abstract

Aim: To evaluate risk of liver fibrosis in patients with type 2 diabetes referred to a primary care liver assessment service.
Methods: A retrospective evaluation of adults referred for liver assessment using vibration controlled transient elastography (VCTE) between January-December 2020. Data recorded at the time of assessment included: age, sex, ethnicity, body mass index (BMI), VCTE (kPa) reading, alcohol consumption and diabetes status. Binary logistic regression was used to examine whether type 2 diabetes, BMI, sex, age and ethnicity were associated with F2/F3 liver fibrosis.
Results: 350 patients received a liver assessment. Median (IQR) age was 58 (47-64) years, 56% were male; 24.6% identified as Black, Asian and Minority Ethnic (BAME); median (IQR) BMI 30.8 (27.3-35.3) kg/m², mean (±SD) VCTE 9.0 kPa (±7.6), and 35.4% had type 2 diabetes. Moderate/severe liver fibrosis (F2/F3) occurred in 59.3% of patients with type 2 diabetes and 25% without diabetes (control) (p < 0.001). Cirrhosis (F4) was found in 28.5% of patients with type 2 diabetes and 8% of control (p < 0.001). Type 2 diabetes, BMI and BAME were all associated with F2/F3 fibrosis (odds ratio (OR) 3.69, 95% confidence interval (CI) 2.19-6.22; 1.14, (1.09-1.20) and 2.04 (1.06-3.94) respectively). Alcohol consumption was not significantly different between type 2 diabetes and control cohort.
Conclusion: Patients with type 2 diabetes referred for liver assessment are at markedly increased risk of liver fibrosis, known to be a cause of end stage liver disease and hepatocellular carcinoma. We recommend that patients with type 2 diabetes should be assessed for liver fibrosis.

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Contributors

Author: Tina Reinson

Author: Christopher Byrne

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