Screening for liver fibrosis by using FibroScan(®) and FibroTest in patients with diabetes

Dig Liver Dis. 2012 May;44(5):413-8. doi: 10.1016/j.dld.2011.12.005. Epub 2012 Jan 27.


Background: Patients with diabetes are at risk for nonalcoholic fatty liver disease leading to cirrhosis. Existing guidelines do not advocate screening for liver related complications amongst persons with diabetes.

Aim: The aim of this prospective study was to identify patients with severe liver fibrosis amongst patients hospitalized for their diabetes, using non-invasive methods, and to evaluate factors associated with severe fibrosis.

Methods: Consecutive patients with type 1 or 2 diabetes had clinical, biological parameters and liver fibrosis evaluation. Severe fibrosis was predicted when FibroTest was >0.59 or liver stiffness >8.7 kPa.

Results: A total of 277 patients were evaluated (type 1 diabetes 52%). The prevalence of severe fibrosis was 15.5%. By univariate analysis, factors associated with severe fibrosis were age, type 2 diabetes, body mass index, metabolic syndrome, previous cardiovascular events, no retinopathy, past history of foot ulcer, and elevated alanine aminotransferase. By multivariate analysis, factors associated with severe fibrosis were age >50 years, type 2 diabetes, no retinopathy, and past history of foot ulcer.

Conclusion: This study showed an elevated prevalence of severe fibrosis in hospitalized diabetic patients, especially patients aged 50 years or older with type 2 diabetes, or with a past history of foot ulcer.

Publication types

  • Clinical Trial

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Apolipoprotein A-I / blood
  • Bilirubin / blood
  • Biomarkers / analysis
  • Diabetes Complications*
  • Diabetic Foot / complications
  • Female
  • Haptoglobins / analysis
  • Humans
  • Liver / diagnostic imaging
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / etiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • ROC Curve
  • Severity of Illness Index
  • Ultrasonography
  • alpha-Macroglobulins / analysis
  • gamma-Glutamyltransferase / blood


  • Apolipoprotein A-I
  • Biomarkers
  • Haptoglobins
  • alpha-Macroglobulins
  • gamma-Glutamyltransferase
  • Bilirubin