Evaluation of Non-Alcoholic Fatty Liver Disease Severity Using FIB-4 Score and Transient Elastography in Type-2 Diabetes Patients

Background: Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease. Fibrosis-4 (FIB-4) score is a screening tool for liver fibrosis detection and Transient elastography (TE) is recommended for liver stiffness measurement (LSM) in primary care settings for patients with metabolic risk factors and FIB-4 levels above 1.3. The present study was conducted to evaluate non-alcoholic fatty liver disease severity using FIB-4 score and transient elastography in type-2 diabetes patients. Material and Methods: Present research was done on 150 cases having Type-2 diabetes and NAFLD. NAFLD was diagnosed based on history, blood investigations and USG whole abdomen. 100 cases were segregated as Low risk [FIB-4 <1.3] whereas 50 as High risk [FIB ≥ 1.3; TE ≥8 kPa] cases. Data collected and recorded on MS excel. Data was analysed using SPSS version 20.0 software. Results: Lipid profile was comparable (p>0.05) in both high and Low risk cases. In Low risk, more cases showed good HbA1c and Grade 1 fatty liver than High risk, depicting a considerable difference (p<0.05). Average elastography values and Mean FIB 4 score were considerably (p<0.05) higher in High risk than Low risk cases. Conclusion: Use of different non-invasive fibrosis scores among patients with type 2 diabetes identifies different proportions of patients with advanced fibrosis. FIB-4 cut-offs results in a decrease in gray-zone results, making referrals to hepatologists more sustainable for the healthcare system.

Keywords: Nonalcoholic fatty liver disease; Diabetes; FIB-4 score; Lipid profile.