PDF | https://doi.org/10.46613/congastro2023-192
This work is licensed under CC BY 4.0
Moran L1, Vallejo V1, Puga M2, Marriott D3, Villacis E1, Garzon M1, Teran Z1, Vera E1, Yepez S1, Romero L1, Carrillo J1, Lopez J1, Oleas R4, Arevalo M3, Buchelli P5, Carvajal J6, Cartagena M7, Marriott E3
1Hospital Teodoro Maldonado Carbo (HTMC), Guayaquil, Ecuador
2Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador
3Universidad de Especialidades Espirtu Santo (UEES), Guayaquil, Ecuador
4John H. Stroger, Jr. Hospital of Cook County, Chicago, Estados Unidos (EEUU)
5Universidad Católica de Santiago de Guayaquil (UCSG), Guayaquil, Ecuador
6Universidad Santiago de Chile, Santiago, Chile
7Hospital El Carmen, Santiago, Chile
BACKGROUND: Liver fibrosis (LF) is the replacement of normal liver tissue by fibrotic tissue. Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) play a role in the LF pathway. Evolution is silent, leading to a late diagnosis. Transient elastography (TE) screening in obesity and diabetes mellitus (DM) is key for early LF identification.
AIM: To determine the grade of LF in patients with obesity and DM.
METHODS: Observational, cross-sectional prospective-collecting study (Dec/2021-Jun/2022). We excluded patients with several alcohol intake, viral hepatitis, autoimmune hepatitis, haemochromatosis or biliary disease. LF in terms of liver stiffness was assessed with TE, based on METAVIR score: F0 and F1, LF absence; F2, F3, and F4, LF. Body mass index (BMI) determined obesity, and clinical records determined DM.
RESULTS: 303 patients, mean age 55.3 ± 12.9 years, 53.3% female, BMI 31.4 ± 6.4 kg/m2, 56% DM. There was a significant association among DM and F2 (68.5%) and F3 (72%), compared with F0-1 and F4 (P=.05). The frequency of different grades of obesity seems to be similar among METAVIR scores (table 1).
CONCLUSIONS: TE screening in patients with DM let to identify an important frequency of F2 and F3 patients. It is necessary to perform population-based prospective studies to confirm this findings.
Table 1. Obesity and DM by METAVIR score.
|
|
Total (n=303) |
F0-1 (n=216) |
F2 (n=54) |
F3 (n=25) |
F4 (n=8) |
-value |
|
Obesity (n=180; 59.4%) |
|
|
|
|
|
.173 |
|
Normal |
41 (13.5) |
32 (14.8) |
7 (13.0) |
– |
2 (25.0) |
|
|
Overweight |
82 (27.1) |
62 (28.7) |
13 (24.1) |
7 (28.0) |
– |
|
|
Obesity-I |
84 (27.7) |
57 (26.4) |
20 (37.0) |
7 (28.0) |
– |
|
|
Obesity-II |
47 (15.5) |
34 (15.7) |
7 (13.0) |
4 (16.0) |
2 (25.0) |
|
|
Obesity-III |
49 (16.2) |
31 (14.4) |
7 (13.0) |
7 (28.0) |
4 (50.0) |
|
|
DM (n=170; 56.1%) |
170 (56.1) |
113 (52.3) |
37 (68.5) |
18 (72.0) |
2 (25.0) |
.05 |