Prevalence and markers of advanced liver disease in people with type 2 diabetes: the Edinburgh type 2 diabetes study

R. M. Williamson, J. F. Price, P. C. Hayes, S. Glancy, B. M. Frier, G. I. Johnston, R. M. Reynolds, M. W. J. Strachan

Research output: Contribution to journalMeeting abstract

Abstract

Background: Type 2 diabetes is a risk factor for progression of non-alcoholic fatty liver disease (NAFLD) to fibrosis and cirrhosis. We examined the prevalence of advanced liver disease in people with type 2 diabetes and analysed the effectiveness of liver function tests (LFTs) as a screening tool. Methods: Participants (n = 939, aged 61–76 years) from the Edinburgh Type 2 Diabetes Study, a randomly selected population of people with type 2 diabetes, underwent abdominal ultrasonography. Hyaluronic acid (HA) and platelet count/spleen diameter ratio (PSR) were used as non-invasive markers of hepatic fibrosis and portal hypertension. Subjects were screened for secondary causes of liver disease that excluded them from a diagnosis of NAFLD. The efficacy of LFTs [alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT)] in screening for liver disease was determined. Results: Cirrhosis was identified by ultrasound in four participants (0.4%). Ten (1.1%) had evidence of portal hypertension (PSR < 909), and two (0.2%) had hepatocellular carcinoma. Fifty-three participants (5.7%) had evidence of hepatic fibrosis (HA > 100 ng/ml in the absence of joint disease); a further 169 had HA > 50 ng/ml. In participants with NAFLD-related fibrosis (HA > 100 ng/ml), 12.5% had an elevated ALT level and 17.5% had an elevated GGT level. Conclusions: The prevalence of hepatic fibrosis and cirrhosis were lower than expected. The use of LFTs to screen for liver disease missed most cases of fibrosis predicted by raised HA levels.
Original languageEnglish
Pages (from-to)S110-S110
Number of pages1
JournalDiabetologia
Volume54
DOIs
Publication statusPublished - 7 Dec 2011
Event47th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD) - Lisbon, Portugal
Duration: 12 Sep 201116 Sep 2011

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