<b>Objective:</b> Type 2 diabetes mellitus (T2DM) is an important risk
factor for the progression of metabolic liver disease to advanced fibrosis.
Here, we provide an estimate of the prevalence of steatosis and fibrosis in US
adults with T2DM based on transient elastography (TE) and identify factors
associated with these conditions.
<p><b>Research
Design and Methods: </b>This is a
cross-sectional study of US adults with T2DM participating in the 2017-2018
cycle of the National Health and Nutrition Examination Survey who were
evaluated by TE. Hepatic steatosis and fibrosis were diagnosed by the median
value of Controlled Attenuation Parameter (CAP) and Liver Stiffness Measurement
(LSM), respectively.</p>
<p><b>Results:</b> Among the 825 patients with reliable TE exams, 484
(53.7%) were assessed using the M probe and 341 (46.3%) using the XL probe.
Liver steatosis (CAP≥274 dB/m), advanced fibrosis (LSM≥9.7 Kpa) and cirrhosis
(LSM≥13.6 Kpa) were present in 73.8% (95% CI 68.5%-78.5%), 15.4% (95% CI
12.2%-19.0%) and 7.7% (95% CI 4.8%-11.9%) of patients, respectively. Mean age
of patients with advanced fibrosis and cirrhosis was 63.7 ± 2.2 years and 57.8
± 1.6 years, respectively. In the multivariable logistic regression model, body
mass index (BMI), non-African American ethnicity and alanine aminotransferase
levels were independent predictors of steatosis, while BMI, non-African
American ethnicity, aspartate aminotransferase and gamma-glutamyltranspeptidase
levels were independent predictors of advanced fibrosis.</p>
<p><b>Conclusions:</b> Prevalence of both liver steatosis and fibrosis are
high in patients with T2DM from the US and obesity is a major risk factor. Our
results support the screening of these conditions among diabetic patients.</p>
High Prevalence of Advanced Liver Fibrosis Assessed by Transient Elastography Among U.S. Adults With Type 2 Diabetes
