Subbramaniam, Subashini A/P
(2016)
Correlation of liver elastography with lipid profile, liver function test, and HbA1c in type II diabetes with non-alcoholic fatty liver disease in Hospital Universiti Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background
Non-alcoholic fatty liver disease (NAFLD) is a range of liver disorders which ranges
from simple accumulation of fat in the hepatocytes (steatosis) to macrovescicular
steatosis, periportal and lobular inflammation (steatohepatitis). The current gold
standard to diagnose liver diseases is biopsy, however this has two major problems: it is
dependent on the sampling area, which may cause an evaluation error in the case of
mild fatty liver, and it is an invasive technique which carries a morbidity rate of 1-5%
and a mortality rate of 0.01-0.1%. Non-invasive imaging tools such as shear wave
elastrography has been proven to be useful for screening and categorizing of chronic
liver disease, however, further evaluation of this tool is needed in different population.
Aim and Objective
This study aimed to assess the associations among liver elastography, lipid profile, liver
function test and HbA1c among type II diabetic patient in Hospital Universiti Sains
Malaysia, in which (i) the prevalence and incidence rate of NAFLD and liver
fibrosis/cirrhosis among type II diabetic patient in Hospital Universiti Sains Malaysia
was determined, respectively; (ii) the mean values of the blood lipid profile, liver
functions test and HBA1c among patient with and without NAFLD were compared; and(iii) the associations between degree of liver elasticity; and blood lipid profil, liver
function test and HBA1c were investigated.
Method
Patients were recruited from Diabetic Clinic, HUSM. Only patients who fulfilled the
selection criteria and provided written consent were enrolled into this study. The
Medical record of the patient was provided by the clinic. Liver elastrography was
performed in Radiology Department, HUSM by Supersonic Imagine Using Shear Wave
Elastography (Siemens Acuson Antares -Premium Edition, Camberley, UK), equipped
with Aixplorer Multiwave. Data were recorded and analysed using SPSS version 22.0.
Result
The prevalence of NAFLD among participant with DM type II was 87%, while the
incidence rate of liver fibrosis among the patients with NAFLD was 11.7% (8/68). The
distribution of METAVIR score among T2DM patients were F0 (60/68), F1 (7/68), and
F2 (1/68). The result revealed very poor correlation between SWE values and part of the
study parameters, which includes HDL, LDL, TG, AST and HbA1c (P>0.05). However,
there were two parameters showed significant weak association between SWE values;
TC (r=0.283; P=0.019) and ALT (r=0.252; P=0.038).
Conclusion
This study had determined to the prevalence of NAFLD and incidence rate of liver
fibrosis among T2DM patients admitted to HUSM. The prevalence of NAFLD was
higher but the incidence rate of liver fibrosis was lower compared to previous study.
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