| Prevalence and markers of advanced liver disease in type 2 diabetes. | |
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MedLine Citation:
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PMID: 22156706 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Type 2 diabetes is a risk factor for progression of non-alcoholic fatty liver disease (NAFLD) to fibrosis and cirrhosis. We examined the prevalence of advanced liver disease in people with type 2 diabetes and analysed the effectiveness of liver function tests (LFTs) as a screening tool. METHODS: Participants (n = 939, aged 61-76 years) from the Edinburgh Type 2 Diabetes Study, a randomly selected population of people with type 2 diabetes, underwent abdominal ultrasonography. Hyaluronic acid (HA) and platelet count/spleen diameter ratio (PSR) were used as non-invasive markers of hepatic fibrosis and portal hypertension. Subjects were screened for secondary causes of liver disease that excluded them from a diagnosis of NAFLD. The efficacy of LFTs [alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT)] in screening for liver disease was determined. RESULTS: Cirrhosis was identified by ultrasound in four participants (0.4%). Ten (1.1%) had evidence of portal hypertension (PSR < 909), and two (0.2%) had hepatocellular carcinoma. Fifty-three participants (5.7%) had evidence of hepatic fibrosis (HA > 100 ng/ml in the absence of joint disease); a further 169 had HA > 50 ng/ml. In participants with NAFLD-related fibrosis (HA > 100 ng/ml), 12.5% had an elevated ALT level and 17.5% had an elevated GGT level. CONCLUSION: The prevalence of hepatic fibrosis and cirrhosis were lower than expected. The use of LFTs to screen for liver disease missed most cases of fibrosis predicted by raised HA levels. |
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Authors:
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R M Williamson; J F Price; P C Hayes; S Glancy; B M Frier; G I Johnston; R M Reynolds; M W J Strachan; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-7 |
Journal Detail:
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Title: QJM : monthly journal of the Association of Physicians Volume: - ISSN: 1460-2393 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9438285 Medline TA: QJM Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Metabolic Unit, Western General Hospital, Edinburgh EH4 2XU, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh EH8 9AG, Department of Hepatology, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, Department of Radiology, Western General Hospital, Edinburgh EH4 2XU, Department of Diabetes, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, Pfizer Global R&D, Sandwich, Kent CT13 9NJ and Endocrinology Unit, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Queens Medical Research Institute, Edinburgh EH16 4TJ, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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