Prevalence and Risk Factors of Liver Fibrosis in Type 2 Diabetic Patients

Abstract

Diabetes, a chronic non-communicable disease (NCD), can lead to complicated diseases if there is poor glycemic control. Type 2 diabetes mellitus (T2DM) is usually related to obesity, dyslipidemia, and metabolic syndrome. These conditions may eventually lead to fatty liver, liver fibrosis, cirrhosis, and cancer. The aim of this study was to determine the prevalence and risk factors associated with liver fibrosis in 380 volunteer T2DM patients aged 35 to 65 years. The fibrosis 4 score (FIB-4 score), according to the criteria of WHO, was used to determine the estimated liver fibrosis. The results showed that the prevalence of liver fibrosis was 1.8% for high-risk, 15.3% for intermediate-risk, and 82.9% for low-risk groups. It was also found that age, diabetes duration, blood creatinine, AST, ALT, and urine protein were significantly higher in T2DM patients with FIB-4 score ≥ 1.45 than in T2DM with FIB-4 score < 1.45 (p < 0.05). In contrast, eGFR and platelet counts were significantly lower in T2DM patients with FIB-4 score ≥ 1.45 than in T2DM patients with FIB-4 score < 1.45 (p < 0.05). The risk factors for liver fibrosis were statistically analyzed by univariate and multivariate analysis. The results showed that increasing age, AST and urine protein resulted in increased  risks of liver fibrosis by 7.3-, 25.1-, and 2.4-fold, respectively (p < 0.05). In conclusion, the FIB-4 scores are noninvasive markers that can be used to evaluate liver fibrosis in patients with T2DM. Risk factors such as age, AST, and urine protein could be monitored to prevent the severity of liver fibrosis.