Type 2 Diabetes Patients Should Be Screened for Liver Disease, Study Suggests

Screening in a primary care setting may help managed care plans avoid long-term costs of complications of type 2 diabetes.

Health plans looking to hold down the cost of complications for type 2 diabetes (T2D) patients may want to screen for biomarkers associated with liver disease, based on the results of a study published in the current issue of Alimentary Pharmacology and Therapeutics. According to the researchers, these screenings involve 2 noninvasive tests that can be done in a primary care setting.

Researchers who screened 100 patients with T2D who did not have any form of liver disease. Each patient underwent magnetic resonance imaging (MRI) with hepatic protein density fat fraction, as well as magnetic resonance elastography (MRE). The patients’ mean age was 59.7 years and mean body mass index (BMI) was 30.8 kg/m2.

Screening found that non-alcoholic fatty liver disease was present in 65% of the patients screened with through the MRI method, while the prevalence of advanced fibrosis was 7.1% through the MRE. Patients with non-alcoholic fatty liver disease were younger with a higher mean BMI and waist circumference and were more likely to have metabolic syndrome (84.6% compared with 40% of patients without non-alcoholic fatty liver disease). Only 26% of those with non-alcoholic fatty liver disease had elevated fatty alanine amino transferase.

“This is the first prospective study that assessed the feasibility of screening for both NAFLD and advanced fibrosis in type 2 diabetic patients in a primary care setting by using two accurate, precise validated noninvasive image-based biomarkers,” the researchers wrote. “The study cohort included a diverse population of patients with T2D that has been managed and followed by primary care providers, and was conducted in the population likely to benefit from such screening program.”

The researchers recommended validating their findings in a larger study before adding these screenings to the standard of care for T2D patients in a primary care setting.

Reference

Doycheva I, Cui J, Nguyen P, et al. Non-invasive screening of diabetics in primary care for NAFLD and advanced fibrosis by MRI and MRE [published online September 15, 2015]. Alimen Pharmcol Ther. 2015; DOI: 10.1111/apt.13405.