Endocrine Abstracts

Introduction

Limited evidence exists for hepatic fibrosis in Type 2 Diabetes (T2DM). NAFLD is an independent risk factor for incident diabetes with trends towards increased risk in women.

Methods

We conducted a cross-sectional, retrospective analysis in 438 women with T2DM.FIB-4 score was used to estimate extent of incidental finding of liver fibrosis.

Results

Mean fibrosis 4 score (FIB-4) was 1 (SD ± 0.66, 95% CI 0.98 to 1.1), Vs (HbA1c < 7%, n = 117, 1.11) and uncontrolled group of diabetes (HbA1c ≥ 7%, n = 321, 1.02); P = 0.21. Mean AST, ALT (u/l) and platelet (109/l) were 23, 24 and 301, respectively. Patients were grouped based on FIB-4 scores (group 1: < 1.45, group 2: ≥ 1.45 < 2.67, group 3: ≥ 2.67 < 3.25, group 4: ≥ 3.25) for HbA1c, duration of diabetes and age (Table 1). Difference in age groups was statistically significant (P < 0.0001) with youngest patients (56.8 years) lowest FIB-4 scores

Conclusion

FIB-4 score was a simple, cost effective tool to identify T2DM women who are at risk of hepatic outcomes without any apparent clinical symptoms of liver disease. Patients with FIB-4 score in the range 1.45–2.67 were provided lifestyle modification and managed by pharmacotherapy options of pioglitazone, vitamin E, SGLT2 inhibitors, GLP-1 agonists and saroglitazar and patients with higher scores (≥ 2.67) were timely referred to hepatologists