Noinvasive fibrosis assessment in fatty liver disease in diabetes patients

Background and Aim Noninvasive tools are well accepted by patients for fibrosis assessment in chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD). Transient elastography (TE) is an accepted alternative to liver biopsy for fibrosis evaluation. NAFLD is quite frequent in clinical practice and it is difficult to identify those patients who have nonalcoholic steatohepatitis (NASH). The aim of this study was to assess the value of simple biological tests (APRI, FIB 4 Index and BARD score) for ruling out the presence of significant and severe fibrosis and their correlation with TE in diabetic patients with NAFLD. Material and Method We conducted a prospective study which included 469 diabetic patients (p) out of which 454 had steatosis (average age 61 ± 9.3 years, 55.1% female), evaluated both by serum markers (TGO, TGP, platelets) and by TE-Fibroscan (Echosens,Paris, France), with incorporated CAP function. Based on specific formulas we calculated APRI, FIB4 index and BARD score. Liver stiffness measurements (LSM) were considered reliable if 10 valid values with an IQR/median 8.5 kPa, severe fibrosis > 10.1kPa, and for steatosis we considered: S1(mild)-230-275 db/m, S2 (moderate)-275-300 db/m, S3 (severe) > 300 db/m. Results We tried to rule out significant fibrosis by using APRI Regarding FIB4 score, we found that 94%p had FIB4 18.3% of patients had a BARD score Conclusion simple tests such as APRI score