Wan Chek, Wan Ahmad Firdaus and Haroon, Raihanah
(2023)
Correlation of Type 2 Diabetes Mellitus with liver fibrosis on
ultrasound elastography: a narrative review.
In: Medical Research Symposium 2023, 07 December 2023, Kuantan, Pahang.
(Unpublished)
Abstract
Introduction: Type 2 diabetes mellitus (DM) patients showed higher prevalence of
developing non-alcoholic fatty liver disease which can further progress to liver
fibrosis due to repetitive liver injury. This may lead to liver cirrhosis with increased
risk for hepatocellular carcinoma. Sonographically, liver fibrosis is quantified using
elastography which measures the degree of liver stiffness, from F0-F4 stages. F0-F2
stages are interpreted as insignificant, while F3-F4 are considered as significant liver
fibrosis. This article reviews the literature surrounding liver fibrosis as a
complication of type 2 DM detected by ultrasound elastography. Materials and
method: A systematic approach was performed using various search engines such
as PubMed, Google Scholar and Elsevier between 2018 to 2022. Results: We reviewed
16 relevant studies out of 41 articles in our analysis. From these articles, all the
studies showed that all type 2 DM patients are prone to develop significant liver
fibrosis, hence increased liver-related mortality. Five studies showed the sensitivity
and specificity of elastography around 80% in diagnosing different stages of liver
fibrosis. Two of the studies (by Kwok et al. (2014) from Hong Kong and Lai et al.
(2018) from Malaysia) showed correlation between DM and obesity with liver fibrosis
on elastography, whereby 70-87% of these patients had histopathologically-proven
liver fibrosis after biopsy. Conclusion: Type 2 DM patients are prone to develop
significant liver fibrosis. Ultrasound elastography showed excellent diagnostic
accuracy to assess the degree of liver fibrosis, potentially eliminating the need for
invasive liver biopsy. Hence, liver should be considered as additional macrovascular
target end-organ damage potentially affected by type 2 DM. However, future studies
are recommended to explore further the effect of different disease control of type
2 DM on the severity of liver fibrosis.
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