Journal
QJM-AN INTERNATIONAL JOURNAL OF MEDICINE
Volume 105, Issue 5, Pages 425-432Publisher
OXFORD UNIV PRESS
DOI: 10.1093/qjmed/hcr233
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Funding
- UK Medical Research Council
- Pfizer Ltd
- Pfizer
- Bayer Health Care Diagnostics Division
- Bristol-Myers Squibb Company
- Roche Diagnostics Corporation
- MRC [G0500877] Funding Source: UKRI
- Medical Research Council [G0500877] Funding Source: researchfish
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Methods: Participants (n = 939, aged 61-76 years) from the Edinburgh Type 2 Diabetes Study, a randomly selected population of people with type 2 diabetes, underwent abdominal ultrasonography. Hyaluronic acid (HA) and platelet count/spleen diameter ratio (PSR) were used as non-invasive markers of hepatic fibrosis and portal hypertension. Subjects were screened for secondary causes of liver disease that excluded them from a diagnosis of NAFLD. The efficacy of LFTs [alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT)] in screening for liver disease was determined. Results: Cirrhosis was identified by ultrasound in four participants (0.4%). Ten (1.1%) had evidence of portal hypertension (PSR < 909), and two (0.2%) had hepatocellular carcinoma. Fifty-three participants (5.7%) had evidence of hepatic fibrosis (HA > 100 ng/ml in the absence of joint disease); a further 169 had HA > 50 ng/ml. In participants with NAFLD-related fibrosis (HA > 100 ng/ml), 12.5% had an elevated ALT level and 17.5% had an elevated GGT level. Conclusions: The prevalence of hepatic fibrosis and cirrhosis were lower than expected. The use of LFTs to screen for liver disease missed most cases of fibrosis predicted by raised HA levels.
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