Screening for liver fibrosis by using a noninvasive biomarker in patients with diabetes.
OBJECTIVE
Patients with diabetes are at risk for nonalcoholic fatty liver disease leading to advanced fibrosis, cirrhosis, and liver cancer. We examined the efficacy of a screening strategy with a noninvasive fibrosis biomarker (FibroTest) in patients with diabetes.


METHODS
We prospectively studied 1131 consecutive patients without a history of liver disease seen for diabetes. The biomarker data were obtained, and patients with presumed advanced fibrosis were reinvestigated by a hepatologist using elastography and, if necessary, ultrasonography, endoscopy, or liver biopsy.


RESULTS
The biomarker predicted advanced fibrosis in 63 of 1131 (5.6%) patients. A total of 45 patients was reinvestigated, and advanced fibrosis was confirmed in 32 patients, a 2.8% (32/1131) prevalence of confirmed advanced fibrosis, 5 cases of cirrhosis, and 4 cases of hepatocellular carcinoma. In the population with type 2 diabetes who were 45 years or older, the prevalence of confirmed advanced fibrosis was 4.3% (30/696), and hepatocellular carcinoma was 5.7 of 1000 (4/696).


CONCLUSIONS
The fibrosis biomarker might be used for the detection of advanced fibrosis in patients with type 2 diabetes.
Service de Diabétologie, APHP-GHPS, Paris, France.
Sophie
S
Jacqueminet
Pascal
P
Lebray
Rachel
R
Morra
Mona
M
Munteanu
Laure
L
Devers
Djamila
D
Messous
Maguy
M
Bernard
Agnes
A
Hartemann-Heurtier
Francoise
F
Imbert-Bismut
Vlad
V
Ratziu
Andre
A
Grimaldi
Thierry
T
Poynard
D000328:Adult; D000368:Aged; D015415:Biomarkers; D001706:Biopsy; D048909:Diabetes Complications; D054459:Elasticity Imaging Techniques; D004724:Endoscopy; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography
D015415:Biomarkers