title: The prevalence of nonalcoholic liver steatosis in patients with type 2 diabetes mellitus in the Czech Republic.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease (NAFLD) is associated with components of the metabolic syndrome (MS) but the prevalence of NAFLD in the Czech Republic is unknown. The aim of this study was to assess the latter in patients with type 2 diabetes (DM2) and to compare the noninvasive fibrosis scores with ultrasound findings in those patients.
  
  
  METHODS
  180 consecutive patients with DM2 (mean age 64.2±9.3 years, 63% men) were examined for liver biochemistry, MS parameters and had liver ultrasound. MS was diagnosed according to the International Diabetes Federation. The diagnosis of NAFLD was based on liver ultrasound. Other aetiology of liver lesion was ruled out. Additionally, AST/ALT ratio, APRI, NAFLD fibrosis score, FIB4 and BARD scores were calculated.
  
  
  RESULTS
  93% of patients met the MS criteria, 79% had NAFLD and 13% had ultrasound signs of fibrosis/cirrhosis. NAFLD patients had greater weight (96.9±19.3 vs 84.7±14.7 kg; P=0.003), BMI (32.6±5.2 vs 29.4±5.4 kg/m(2); P=0.007), waist circumference (113.8±12.8 vs 107.1±10.3 cm; P=0.033), ALT (0.73±0.57 vs 0.55±0.53 µkat/L, P=0.007) and triglyceridaemia (1.9±1.4 vs 1.4±1 mmol/L; P=0.005) than patients without NAFLD. There were no significant differences in age, sex, cholesterol, fasting glycaemia or glycated haemoglobin. Of calculated scores only the NAFLD fibrosis score revealed significant differences between patients with and without ultrasound signs of fibrosis/cirrhosis (1.027±2.228 vs -0.118±1.402, P=0.026).
  
  
  CONCLUSIONS
  Patients with DM2 had in the majority of cases NAFLD which was related to weight, BMI, waist circumference and serum triglycerides. The validity of the liver fibrosis scoring system has to be assessed in those patients in the future.
authors.affiliation: 4th Department of Internal Medicine, 1st Medical Faculty, Charles University in Prague, Czech Republic.
authors.forename: Karel
authors.initials: K
authors.lastname: Dvorak
authors.affiliation: 4th Department of Internal Medicine, 1st Medical Faculty, Charles University in Prague, Czech Republic.
authors.forename: Radvan
authors.initials: R
authors.lastname: Hainer
authors.affiliation: 4th Department of Internal Medicine, 1st Medical Faculty, Charles University in Prague, Czech Republic.
authors.forename: Jaromir
authors.initials: J
authors.lastname: Petrtyl
authors.affiliation: 4th Department of Internal Medicine, 1st Medical Faculty, Charles University in Prague, Czech Republic.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Zeman
authors.affiliation: 4th Department of Internal Medicine, 1st Medical Faculty, Charles University in Prague, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Vareka
authors.affiliation: 4th Department of Internal Medicine, 1st Medical Faculty, Charles University in Prague, Czech Republic.
authors.forename: Ales
authors.initials: A
authors.lastname: Zak
authors.affiliation: 4th Department of Internal Medicine, 1st Medical Faculty, Charles University in Prague, Czech Republic.
authors.forename: Renata
authors.initials: R
authors.lastname: Sroubkova
authors.affiliation: 4th Department of Internal Medicine, 1st Medical Faculty, Charles University in Prague, Czech Republic.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Svestka
authors.affiliation: Institute of Medical Biochemistry and Laboratory Diagnostics, 1st Medical Faculty, Charles University in Prague.
authors.forename: Libor
authors.initials: L
authors.lastname: Vitek
authors.affiliation: 4th Department of Internal Medicine, 1st Medical Faculty, Charles University in Prague, Czech Republic.
authors.forename: Radan
authors.initials: R
authors.lastname: Bruha
mesh_terms: D000368:Aged; D018153:Czech Republic / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: cirrhosis; fibrosis; metabolic syndrome; non-alcoholic fatty liver disease; steatosis; type 2 diabetes mellitus