J Korean Med Sci.  2014 Aug;29(8):1113-1119. 10.3346/jkms.2014.29.8.1113.

Relationship of Liver Stiffness and Controlled Attenuation Parameter Measured by Transient Elastography with Diabetes Mellitus in Patients with Chronic Liver Disease

• Ahn JM
• Paik YH
• Kim SH
• Lee JH
• Cho JY
• Sohn W
• Gwak GY
• Choi MS
• Lee JH
• Koh KC
• Paik SW
• Yoo BC

• KMID: 2129607
• DOI: http://doi.org/10.3346/jkms.2014.29.8.1113

Abstract

High prevalence of diabetes mellitus in patients with liver cirrhosis has been reported in many studies. The aim of our study was to evaluate the relationship of hepatic fibrosis and steatosis assessed by transient elastography with diabetes in patients with chronic liver disease. The study population consisted of 979 chronic liver disease patients. Liver fibrosis and steatosis were assessed by liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) on transient elastography. Diabetes was diagnosed in 165 (16.9%) of 979 patients. The prevalence of diabetes had significant difference among the etiologies of chronic liver disease. Higher degrees of liver fibrosis and steatosis, assessed by LSM and CAP score, showed higher prevalence of diabetes (F0/1 [14%], F2/3 [18%], F4 [31%], P<0.001; S0/1 [15%], S2 [17%], S3 [26%], P=0.021). Multivariate analysis showed that the independent predictive risk factors for diabetes were hypertension (OR, 1.98; P=0.001), LSM F4 (OR, 1.86; P=0.010), male gender (OR, 1.60; P=0.027), and age>50 yr (OR, 1.52; P=0.046). The degree of hepatic fibrosis but not steatosis assessed by transient elastography has significant relationship with the prevalence of diabetes in patients with chronic liver disease.

Keyword

Chronic Liver Disease; Diabetes Mellitus; Transient Elastography; Fibrosis; Steatosis

MeSH Terms

Causality
Comorbidity
Diabetes Complications/diagnosis/epidemiology/physiopathology
Elastic Modulus
Elasticity Imaging Techniques/methods/statistics & numerical data
End Stage Liver Disease/*epidemiology/physiopathology/*ultrasonography
Fatty Liver/*epidemiology/physiopathology/*ultrasonography
Female
Humans
Image Interpretation, Computer-Assisted/methods
Incidence
Liver/physiopathology/ultrasonography
Liver Cirrhosis/*epidemiology/physiopathology/*ultrasonography
Male
Middle Aged
Reproducibility of Results
Republic of Korea/epidemiology
Risk Factors
Sensitivity and Specificity

Figure

• 

  Fig. 1 The prevalence of diabetes according to the LSM and CAP score in patients with chronic liver disease. (A) The prevalence of diabetes according to the degree of liver fibrosis, measured by LSM in patients with chronic liver disease (F0/1 [14%], F2/3 [18%], F4 [31%], P < 0.001). (B) The prevalence of diabetes according to the degree of liver steatosis, measured by CAP score in patients with chronic liver disease (S1 [15%], S2 [17%], S3 [26%], P = 0.021). LSM, liver stiffness measurement; CAP, controlled attenuation parameter.

• 

  Fig. 2 The prevalence of diabetes according to the LSM and CAP score in patients with chronic hepatitis B. (A) The prevalence of diabetes according to the degree of liver fibrosis, measured by LSM in patients with chronic hepatitis B (F0/1 [13%], F2/3 [15%], F4 [34%], P < 0.001). (B) The prevalence of diabetes according to the degree of liver steatosis, measured by CAP score in patients with chronic hepatitis B (S0/1 [14%], S2 [13%], S3 [26%], P = 0.012). LSM, liver stiffness measurement; CAP, controlled attenuation parameter.

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