How to Cite
1.
Quevedo Ramírez N, Pérez Castillo R, Sánchez Gendriz IV. Correlation between serological and echographic markers to patients with non-alcoholic fatty liver and diabetes mellitus type 2. Rev.méd.sinerg. [Internet]. 2019Aug.1 [cited 2024Nov.21];4(8):e264. Available from: https://revistamedicasinergia.com/index.php/rms/article/view/264
Abstract
Introduction: Type 2 diabetics have a high risk of suffering from fatty liver disease alcoholic. Detection and early intervention may reduce cardiovascular risk, prevent their complications and reduce their progression. The objective is to evaluate the correlation between the markers by abdominal ultrasound and indirect serological markers in type 2 diabetic patients with non-alcoholic fatty liver. Method: A descriptive, correlational and transversal study was carried out. Thirty three patients were studied to evaluate the severity of hepatic steatosis by abdominal ultrasound. The indirect serological markers were glycemia, total cholesterol, triglycerides, alanine transaminase, aspartate transaminase and ganmaglutamyl transferase. The results of both markers by Student's T test, Kolmogorov adjustment test and variance analysis. Results: The average age was 54.9 ± 9.1 years. Moderate hyperechogenic marker (45.5%) with diffuse pattern was more frequently observed. The most altered indirect serological markers were glycemia (n = 29, 87.8%), triglycerides (n = 25, 75.8%), total cholesterol (n = 22,66.7) and alanine-transaminase (n = 21). 63.6%). The levels of glycemia and enzyme ASAT offered Rho Spearman values of r = 0.65 and r = 0.61 respectively. Conclusion: The development of nonalcoholic fatty liver appears to be linked to chronic metabolic decompensation and insulin resistance. The levels of glycemia and ASAT enzyme were the indirect serological markers that had the highest statistical correlation with the degrees of liver injury diagnosed by abdominal ultrasound. It is recommended the use of predictive models from clinical variables, Indirect and ultrasound serological markers in the diagnosis and follow-up of patients with non-alcoholic fatty liver for its simplicity, and good correlation with more techniques complex. Risk stratification with the use of these tools enables implement early measures to reduce morbidity and mortality due to cardiovascular causes.
Keywords
non-alcoholic fatty liver disease. fatty liver. diabetes mellitus type 2. ultrasonics.
References
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2. Hatziagelaki E, Drosos E, Counta A, Tsiavou A, Matthew E, Dimitriadis G. Predictor sofIm paired glucose regulation in patients with Non-Alcoholic fatty liver disease. 2011; 7: p. 1-7.
3. Bonapace S, Valbusa F, Bertolini L, Pichiri I, Montovani A, Rossi A. Non-alcoholic fatty liver disease is associated with aortic valve sclerosis in patients with type 2 Diabetes Mellitus. Plos one. 2014; 9(2): p. 1-6.
4. Lonardo A, Sookoian S, Pirola C, Targher G. Atherosclerosis. [Internet].; 2015 [citado 2019 Marzo 3] . Disponible en: http://dx.doi.org/10.1016/j.metabol.2015.09.017 .
5. Wanless I, Lentz J. Fatty liver hepatitis (steatohepatitis) and obesity: an autopsy study with analysis of risk factors. Hepatology. 1990; 12: p. 1106 -1110.
6. Lizardi-Cervera J, Becerra Laparra I, Chávez-Tapia NC, Ramos Ostos ME, Uribe Esquivel M. Prevalencia de hígado graso no alcohólico y síndrome metabólico en población asintomática. Revista Gastroenterología Mexicana. 2006; 71(4): p. 453-459.
7. Longo DL, Kasper DL, Jameson JL, Fauci AS, Hauser SL, Loscalzo J. HARRISON. PRINCIPIOS DE MEDICINA INTERNA. 18th ed.: McGRAW-HILL INTERAMERICANA; 2012.
8. Younossi Z, Koenig A, Abdelatif D, etal. Global epidemiology of nonalcoholic fatty liver disease, Meta-analytic assessment of prevalence, incidenceand outcomes. Hepatology. 2016; 64: p. 73-84.
9. Younossi Z, Stepanova M, Afendy M, Colmillo A, Srishord M, Changes E. El predominio de las causas más comunes de enfermedades del hígado crónicas en los Estados Unidos de 1988 a 2008. Gastroenterol y Hepatol. 2011; 9: p. 524–530.
10. Diehl AM, Day C. Cause, Pathogenesis, and Treatment of Nonalcoholic Steatohepatitis. N Engl J Med. 2017; 377: p. 2063-2072.
11. Ministerio de Salud Pública. Anuario Estadístico de Salud. La Habana:, Dirección de registros médicos y estadísticas de Salud; 2018. Aprox. 193 p. Disponible en: http://bvscuba.sld.cu/anuario-estadistico-de-cuba/
12. Santiesteban Rodríguez M. Ultrasonido y Tomografía Axial Computarizada en el diagnóstico de la Esteatosis Hepática no Alcohólica. Tesis de Terminacion de Especialidad. La Habana: Hospinal Nacional "Hermanos Ameijeiras", Imagenología; 2013.
13. Elvírez G, Castellanos F, Santillán L, Dorta G, Galbán G, Arús S. Liver Stiffness Reference Values for Healthy Cuban Adults. MEDICC Review.. 2018 January ; 20(1): p. 24-28.
14. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016; 64: p. 1388–1402. Disponible en: http://refhub.elsevier.com/S0326-4610(16)30065-1/sbref0385.
15. Chalasani N, Younossi Z, Lavine J, Diehl A, Brunt E, Cus i, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2012; 55: p. 2005-2023. Disponible en: http://refhub.elsevier.com/S0326-4610(16)30065-1/sbref0560.
16. Caballería L, Saló J, Berzigotti A, Planas R. Hígado graso no alcohólico. Documento de posicionamiento de la Sociedad Catalana de Gastroenterología. Gastroenterol y Hepatol. 2014; 6: p. 372-383.
17. Khov N, Sharma A, Riley T. Bedside ultrasound in the diagnosis of non-alcoholic fatty liver disease. World Journal of Gastroenterol. 2014; 20(22): p. 6821 -6125.
18. Lee T, Han SH YJ, Kim D, Ahmed M. Prediction of advanced fibrosis in Non-alcoholic fatty liver disease: an enhanced model of BARD score. Gut and Liver. 2013; 7(3): p. 323-328.
19. Goulart A, Oliveira I, Alencar A, Santos M. Diagnostic accuracy of a non-invasive hepatic ultrasound score for non-alcoholic fatty liver disease(NAFLD) in the Brazilian longitudinal study of adult health (ELSA-Brasil). Sao Paulo Medic Journal. 2014; 133(2): p. 115- 124.
20. Machado M, Cortez Pinto H. Non-alcoholic fatty liver disease: What the clinician needs to know. World Journal of Gastroenterol. 2014; 20(36): p. 12956-12980.
21. Alkhouri N, Mc Cullough A. Non-invasive diagnosis of NASH and liver fibrosis within the spectrum of NAFLD. Gastroenterol and Hepatol. 2012; 8(10): p. 661-668.
22. Kumar R, Rastogi A, Sharma M. Liver stiffness measurements in patients with different stages of nonalcoholic fatty liver disease: diagnostic performance and clinic pathological correlation. Gastroenterol and Hepatol. 2013; 58: p. 265-274.
23. Satapathy S, Sanyal A. Epidemiology and natural history of nonalcoholic fatty liver disease. 2015;: p. 221–235. Disponible en: http://refhub.elsevier.com/S0326-4610(16)30065-1/sbref0295.
24. Lindenmeyer C, McCullough A. The Natural History of Nonalcoholic Fatty Liver Disease And Envolving View. Clin Liver Dis. 2018; 22: p. 11-21.
25. Stengel J, Asike M, Torres D, Shaw J, Landt C, Harrison S, et al. El predominio de la enfermedad del hígado graso no alcohólico y la esteatohepatitis no alcohólica en una población principalmente de mediana edad, un estudio probable utilizando el ultrasonido y la biopsia. Gastroenterol.. 2011; 140: p. 124-131.
26. Sun B. Fibroscan for diagnosis and treatment of chronic liver disease. Chinese Journal of Digestology. 2015; 23(9): p. 1433.
27. Graffigna M, Catoira N, Soutelo J, Azpelicueta A, Berg G, Perel C, et al. Diagnóstico de esteatosis hepática por métodos clínicos, bioquímicos y por imágenes. rev argent endocrinol metab. 2017; 54(1): p. 37–46. Disponible en: http://dx.doi.org/10.1016/j.raem.2016.12.001
28. Suárez González M, López Mejia VM, Eirin Rey JM, González González EL, Medina Garrido Y, Díaz Oliva SE. Enfermedad hepática grasa no alcohólica. Algunas consideraciones diagnósticas. Acta Médica del Centro. 2017; 11(2): p. Aprox. 9. Disponible en: http://www.revactamedicacentro.sld.cu.
29. Hui E, Xu A, Yang H, Lam K. Obesity as the common soil of non-alcoholic fatty liver disease and diabetes: Role of adipokines. Journal of Diabetes Investigation. 2013; 4(5): p. 413-425.
30. Ahmed M. Non-alcoholic fatty liver disease in 2015. World J Hepatol. 2015. [Internet]; 7: p. 1450–1459. Disponible en: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4462685&tool=pmcentrez&rendertype=Abstract.
31. Zhang Q, Lu L. Nonalcoholic fatty liver disease: dyslipidemia, risk for cardiovascular complications, and treatment strategy. J Clin Transl Hepatol. 2015; 3: p. 78–84. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/26357637.
32. Fruci B, Giuliano S, Mazza A, Malaguarnera R, Belfiore A. Non-alcoholic fatty liver: a possible new target for type 2 diabetes prevention and treatment. International Journal of Molecular Sciences. 2013; 14: p. 22933-22966.
33. Leite N, Villela Nogueira C, Cardoso C, Salles G. Non-alcoholic fatty liver disease and diabetes: from physiopathological interplay to diagnosis and treatment. World Journal of Gastroenterol. 2014; 20(26): p. 8377-8392.
34. Athyros V, Tziomalos K, Katsiki N, Doumas M, Karagiannis A, Mikhailidis D. Cardiovascular risk across the histological spectrum and the clinical manifestations of non-alcoholic fatty liver disease: an update. World Journal of Gastroenterology. 2015; 21(22): p. 6820-6834.
35. Arab J, Candia R, Zapata R, Muñoz C, Arancibia J, Poniachik J. Management of non-alcoholic fatty liver disease: An evidence-based clinical practice review. World Journal of Gastroenterol. 2014; 20(34): p. 12182-12201.
36. Buzzeti E, Lombardi R, De Luca L, Tsochatzis E. Non-invasive assessment of fibrosis in patients with non-alcoholic fatty liver disease. International Journal of Endocrinology. 2015; 34(28): p. 1 -9.
37. S B, Valbusa F, Bertolini L, Pichiri I, Montovani A, Rossi A, et al. Non-alcoholic fatty liver disease is associated with aortic valve sclerosis in patients with type 2 Diabetes Mellitus. Plos one. 2014 February; 9(2): p. 1 -6.
38. Armstrong M, Hazlehurst J, Parker R, Koushiappi E, Mann J, Sheeba K, et al. Severe asymptomatic non-alcoholic fatty liver disease in routine diabetes care; a multi-disciplinary team approach to diagnosis and management. Q Journal Medical. 2014; 107: p. 33-41.
39. Lllalukka S, Yki-Jarvinen H. Non-alcoholic fatty liver disease and risk of Type 2 diabetes. Best Practice and Research Clinical Endocrinology and Metabolism. 2016;: p. 1-11.
40. Villarejo Botija M, Prieto Zancudo C, Martín Fuertes L. Evaluación de la fibrosis en la esteatosis hepática no alcohólica con fibroscán. med gen y fam. 2015; 4(1): p. 25–29.
41. Spengler E, Loomba R. Recommendations for diagnosis, referral for liver biopsy, and treatment of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Mayo Clinic Proceedings. 2015;: p. 1233–1246. Disponible en: http://refhub.elsevier.com/S0326-4610(16)30065-1/sbref0555.
42. Lee S, Park S. Radiologic evaluation of non-alcoholic fatty liver disease. World Journal of Gastroenterol.. 2014; 20(23): p. 7392-73402.
43. Singh D, Das C, Baruah M. Imaging of non alcoholic fatty liver disease: A road less travelled. Indian J Endocrinol Metab. 2013; 17: p. 990–995. Disponible en: http://wwwpubmedcentral.nih.gov/articlerender.fcgi?artid=3872717&tool=pmcentrez&rendertype=Abstract.
44. Csendes P, Paolinelli P, Busel D, Venturelli V, Rodríguez J. Hígado graso: ultrasonido y correlación anátomo-patológica. Rev Chil Radiol. 2004; 10(2): p. 50-52.
45. Friedrich Rust M, Poynard T, Castera L. Critical comparison of elastography methods to assess chronic liver disease. Rev Gastroenterol Hepatol. 2016; 13(7): p. 402-411.
46. Álvarez D, Anders M. Utilidad de la Elastografía de transición (Fibroscan) en la evaluación de la fibrosis hepática en pacientes con hepatopatía crónica. Rev Med Bue Air. 2012; 72(1): p. 10-14.
47. Yoneda M, Suzuki K, Kato S, Fujita K, Nozaki Y, Hosono K, et al. Nonalcoholic fatty liver disease: US-based acoustic radiation force impulse elastography.. Radiol. 2010; 256: p. 640-647.
48. Loomba R, Abraham M, Tech B, etal. Association between diabetes, family history of diabetes and risk of nonalcoholic steatohepatitis and fibrosis. Hepatology. 2012; 56(3): p. 943–951.
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