Screening for hepatic fibrosis and steatosis in Turkish patients with type 2 diabetes mellitus: A transient elastography study

Turk J Gastroenterol. 2019 Mar;30(3):266-270. doi: 10.5152/tjg.2018.18559.


Background/aims: Non-alcoholic fatty liver disease is highly prevalent in patients with type 2 diabetes mellitus (T2DM). The aim of the present study was to investigate the potential usefulness of transient elastography (TE), which is a technique that allows measuring both fibrosis and liver fat content simultaneously, as a screening tool for hepatic involvement in Turkish patients with T2DM.

Materials and methods: We obtained liver stiffness measurements (LSMs, as a measure of fibrosis) and controlled attenuation parameter (CAP, as a marker of steatosis) in 124 (46 males and 78 females; mean body mass index (BMI): 33.2±6.6 kg/m2) Turkish patients with T2DM. The prevalence rates of overweight, obesity, and metabolic syndrome in our sample were 28.2%, 64.5%, and 77.4%, respectively. Probe-specific LSM cut-off values were used to define advanced fibrosis (>F3) and cirrhosis (F4) (M probe: F3=9.6-11.4 kPa, F4 >11.5 kPa and XL probe: F3=9.3-10.9 kPa, F4 >11.0 kPa). Mild, moderate, and severe steatosis were defined as CAP 222-232 dB/m, CAP 233-289 dB/m, and CAP >290 dB/m, respectively.

Results: Advanced fibrosis and cirrhosis were identified in 21 (16.9%) and 10 (8.0%) patients, respectively. TE-defined hepatic steatosis (CAP>222 dB/m) was detected in 117 (94.3%) patients. Mild, moderate, and severe steatosis were identified in 0, 29, and 88 patients, respectively.

Conclusion: TE is a useful non-invasive imaging modality to screen for liver involvement in Turkish patients with T2DM. High rates of TE-defined fibrosis and steatosis in our sample reflect the presence of an elevated mean BMI.

Publication types

  • Evaluation Study

MeSH terms

  • Biomarkers / analysis
  • Body Mass Index
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diagnostic imaging*
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Liver / diagnostic imaging
  • Liver / pathology
  • Liver Cirrhosis / diagnostic imaging*
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / etiology
  • Male
  • Mass Screening / methods*
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / diagnostic imaging
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / diagnostic imaging*
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / etiology
  • Obesity / complications
  • Obesity / diagnostic imaging
  • Obesity / epidemiology
  • Prevalence
  • Turkey / epidemiology


  • Biomarkers