Prevalence and risk factors for steatosis and liver fibrosis measured by magnetic resonance elastography in adults with cystic fibrosis-related diabetes

Gutierrez Ana Pinar; Rey Silvia Garcia; Carmen Roque Cuellar Maria del; Sanchez Andres Jimenez; Angeles Pizarro; Gallego Esther Quintana; Castell Francisco Javier; Manuel Romero-Gomez; Alfonso Soto; Garcia-Luna Pedro Pablo

doi:10.1530/endoabs.99.EP65

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Endocrine Abstracts (2024) 99 EP65 | DOI: 10.1530/endoabs.99.EP65

ECE2024 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (383 abstracts)

Prevalence and risk factors for steatosis and liver fibrosis measured by magnetic resonance elastography in adults with cystic fibrosis-related diabetes

Ana Piñar Gutiérrez , Silvia García Rey , María del Carmen Roque Cuéllar , Andrés Jiménez Sánchez , Ángeles Pizarro , Esther Quintana Gallego , Francisco Javier Castell , Manuel Romero-Gomez , Alfonso Soto & Pedro Pablo Garcia-Luna

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Virgen del Rocío University Hospital, Sevilla, Spain

Introduction: Cystic fibrosis-related diabetes (CFRD) has a prevalence of 40-50% in adults. Given what we know about metabolic liver disease, studies are needed to assess whether CFRD is also related to steatosis (LS) and liver fibrosis (LF).

Objectives: To determine the prevalence of LS and LF by magnetic resonance elastography (Mre) in a cohort of adults with CFRD. Secondary: to determine the diagnostic yield of transitional elastography (Fibroscan®) and the factors associated with both entities.

Methods: Cross-sectional study of adults with CFRD in a multidisciplinary unit. Clinical evaluation, morphofunctional assessment, MRe, transitional elastography and noninvasive markers were performed. Quantitative variables are expressed as n(%); qualitative variables as P50(P25-P75). Diagnostic accuracy tests were performed. Logistic regression was performed to study risk factors.

Results: n=28. Women=15(53.6%). Age=34(28.7-40.5)years. Time of evolution=28(19.5-34)years. Malnutrition(GLIM)=15(53.6%). Exocrine pancreatic insufficiency=26(92.9%). BMI=23.2(19.7-24.5)kg/m². Insulin treatment=20(71.4%). The prevalence of LS was 25% and of LF 32.1%. In Fibroscan® it was 28.6% (71.4% sensitivity and 85.7% specificity) and 17.9% (55.5% sensitivity and 100% specificity) respectively. The AUROC of the Fibroscan® was 0.915(0.81-1) in HD and 0.936(0.838-1) in FH. We did not find any factors associated with LS. Those associated with LF are shown in the Table. Multivariate analysis could not be performed due to the low sample size.


	OR(CI 95%)	p
Hemoglobin	5.6(1.01-338.59)	0.05
Total bilirubin	11.46(1.032-127.3)	0.047
Platelets	0.981(0.964-0.998)	0.031
Lymphocytes	0.038(0.002-0.615)	0.021
AST	1.128(1.02-1.247)	0.019
Vitamin A	0.866(0.752-0.997)	0.046
Vitamin E	0.997(0.993-1)	0.047

Conclusions: This is the first study of LS and LF in adults with CFRD performed with MRe. The prevalence was 25% and 31.1% respectively. FibroScan® demonstrated excellent diagnostic accuracy. Alterations in blood count and transaminases, as well as fat-soluble vitamin deficiencies seem to be associated with increased risk of LF.