title: Screening for liver fibrosis by using FibroScan(®) and FibroTest in patients with diabetes.
abstract: BACKGROUND
  Patients with diabetes are at risk for nonalcoholic fatty liver disease leading to cirrhosis. Existing guidelines do not advocate screening for liver related complications amongst persons with diabetes.
  
  
  OBJECTIVE
  The aim of this prospective study was to identify patients with severe liver fibrosis amongst patients hospitalized for their diabetes, using non-invasive methods, and to evaluate factors associated with severe fibrosis.
  
  
  METHODS
  Consecutive patients with type 1 or 2 diabetes had clinical, biological parameters and liver fibrosis evaluation. Severe fibrosis was predicted when FibroTest was >0.59 or liver stiffness >8.7 kPa.
  
  
  RESULTS
  A total of 277 patients were evaluated (type 1 diabetes 52%). The prevalence of severe fibrosis was 15.5%. By univariate analysis, factors associated with severe fibrosis were age, type 2 diabetes, body mass index, metabolic syndrome, previous cardiovascular events, no retinopathy, past history of foot ulcer, and elevated alanine aminotransferase. By multivariate analysis, factors associated with severe fibrosis were age >50 years, type 2 diabetes, no retinopathy, and past history of foot ulcer.
  
  
  CONCLUSIONS
  This study showed an elevated prevalence of severe fibrosis in hospitalized diabetic patients, especially patients aged 50 years or older with type 2 diabetes, or with a past history of foot ulcer.
authors.affiliation: Service d'Hépato-Gastroentérologie, Hôpital Haut-Lévêque, Pessac, France. victor.deledinghen@chu-bordeaux.fr
authors.forename: Victor
authors.initials: V
authors.lastname: de Lédinghen
authors.forename: Julien
authors.initials: J
authors.lastname: Vergniol
authors.forename: Concepcion
authors.initials: C
authors.lastname: Gonzalez
authors.forename: Juliette
authors.initials: J
authors.lastname: Foucher
authors.forename: Elisa
authors.initials: E
authors.lastname: Maury
authors.forename: Louise
authors.initials: L
authors.lastname: Chemineau
authors.forename: Sandrine
authors.initials: S
authors.lastname: Villars
authors.forename: Henri
authors.initials: H
authors.lastname: Gin
authors.forename: Vincent
authors.initials: V
authors.lastname: Rigalleau
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016632:Apolipoprotein A-I / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000032:analysis; D048909:Diabetes Complications; D017719:Diabetic Foot / Q000150:complications; D005260:Female; D006242:Haptoglobins / Q000032:analysis; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D014463:Ultrasonography; D000511:alpha-Macroglobulins / Q000032:analysis; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D016632:Apolipoprotein A-I; D015415:Biomarkers; D006242:Haptoglobins; D000511:alpha-Macroglobulins; D005723:gamma-Glutamyltransferase; D001663:Bilirubin