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Introduction: Metabolic dysfunction associated fatty liver disease (MAFLD) was suggested recently as a more appropriate nomenclature to describe the liver disease associated with known metabolic dysfunction .Type 2 Diabetes is a risk factor for MAFLD, steatohepatitis and patients are at increased risk to developing liver fibrosis and need to be more investigated. Aim: To investigate which MAFLD patients with type 2 diabetes have higher risk for advanced fibrosis. Methods: Patients in diabetes clinic, without known hepatic diseases and without significant alcohol intake (< 21 drinks per week), were voluntarily selected to perform liver ultrasound, liver stiffness and CAP measurements using Fibroscan (Echosens, Paris, France) and serological tests for B and C hepatitis to exclude viral causes of liver disease. Subjects were submitted to a complete clinical examination and laboratory tests. Results: 90 patients were included in this cross-sectional analysis. Overall, 12,2% (11 patients) had advanced fibrosis (liver stiffness > 8,7 Kpa) and 23% (21 patients) had severe steatosis (Grade 3 steatosis; CAP> 290 db/m) based on transient elastography. Factors associated with significant fibrosis were age over 60 years old, alanine amino transferase (ALT) elevation, low HDL (lower than 40), triglycerides elevation, higher BMI and severe steatosis. Conclusion: Prevalence of advanced fibrosis and severe steatosis in patients with type 2 diabetes and MAFLD is very high (12,2% and 23% respectively), what makes screening of these high-risk patients very important. Risk factors such as elevated glycated hemoglobin, higher BMI, triglycerides, ALT and CAP measurements on Fibroscan and low HDL indices are considered to be associated to advanced liver fibrosis. |
