全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Risk Factors for Liver Fibrosis in Patients with Type 2 Diabetes Mellitus and Metabolic Dysfunction–Associated Steatotic Liver Disease in Brazzaville

DOI: 10.4236/ojemd.2025.158014, PP. 142-153

Keywords: Type 2 Diabetes Mellitus, Metabolic Dysfunction-Associated Steatotic Liver Disease, Advanced Fibrosis, Brazzaville

Full-Text   Cite this paper   Add to My Lib

Abstract:

Introduction: Introduction: Type 2 diabetes mellitus is a factor in the initiation and progression of metabolic dysfunction-associated steatotic liver disease (MASLD) to its severe forms with hepatic fibrosis, with a risk of progression to cirrhosis and hepatocellular carcinoma. Hepatic fibrosis has prognostic value in patients with type 2 diabetes mellitus and MASLD. The aim of this study was to investigate the risk factors for hepatic fibrosis in subjects with type 2 diabetes and MASLD in Brazzaville. Patients and Methods: Cross-sectional study and analysis were conducted over 11 months at Brazzaville University Hospital and SUZA Clinic, including patients with type 2 diabetes and MASLD who underwent non-invasive evaluation of liver fibrosis by elastometry or Fibroscan?. Results: The study included 120 patients with a median age of 56 years (50.64), with a clear female predominance. The mean duration of diabetes mellitus was 6.1 ± 5 years. Patients were treated with oral antidiabetics (53.3%) and had a mean glycated hemoglobin of 8.75 ± 1.47%. Liver fibrosis was present in 52 patients (43.3%). Advanced fibrosis was present in 32.6% of cases. Hepatic fibrosis was significantly associated with metabolic syndrome (p = 0.000), severe steatosis (p = 0.012), chronic complications of diabetes mellitus (p = 0.04), dyslipidemia (p = 0.000), and insulin therapy (p = 0.0013). Conclusion: Hepatic fibrosis is common in patients with type 2 diabetes mellitus and MASLD. Its presence is statistically significantly related to metabolic syndrome, dyslipidemia, severe steatosis, insulin therapy, and chronic complications of diabetes mellitus.

References

[1]  Młynarska, E., Czarnik, W., Dzieża, N., Jędraszak, W., Majchrowicz, G., Prusinowski, F., et al. (2025) Type 2 Diabetes Mellitus: New Pathogenetic Mechanisms, Treatment and the Most Important Complications. International Journal of Molecular Sciences, 26, Article 1094.
https://doi.org/10.3390/ijms26031094
[2]  European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) and European Association for the Study of Obesity (EA-SO) (2024) EASL-EASD-EASO Clinical Practice Guidelines on the Management of Meta-Bolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Journal of Hepatology, 81, 492-542.
[3]  Cusi, K., Abdelmalek, M.F., Apovian, C.M., Balapattabi, K., Bannuru, R.R., Barb, D., et al. (2025) Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in People with Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association. Diabetes Care, 48, 1057-1082.
https://doi.org/10.2337/dci24-0094
[4]  Younossi, Z.M., Kalligeros, M. and Henry, L. (2025) Epidemiology of Metabolic Dysfunction-Associated Steatotic Liver Disease. Clinical and Molecular Hepatology, 31, S32-S50.
https://doi.org/10.3350/cmh.2024.0431
[5]  Ferdous, S. and Ferrell, J.M. (2024) Pathophysiological Relationship between Type 2 Diabetes Mellitus and Metabolic Dysfunction-Associated Steatotic Liver Disease: Novel Therapeutic Approaches. International Journal of Molecular Sciences, 25, Article 8731.
https://doi.org/10.3390/ijms25168731
[6]  Harrison, S.A., Frias, J.P., Lucas, K.J., Reiss, G., Neff, G., Bollepalli, S., et al. (2025) Safety and Efficacy of Efruxifermin in Combination with a GLP-1 Receptor Agonist in Patients with NASH/MASH and Type 2 Diabetes in a Randomized Phase 2 Study. Clinical Gastroenterology and Hepatology, 23, 103-113.
https://doi.org/10.1016/j.cgh.2024.02.022
[7]  Sun, Y., Shan, X., Li, M., Niu, Y., Sun, Z., Ma, X., et al. (2025) Autoimmune Mechanisms and Inflammation in Obesity-Associated Type 2 Diabetes, Atherosclerosis, and Non-Alcoholic Fatty Liver Disease. Functional & Integrative Genomics, 25, Article No. 84.
https://doi.org/10.1007/s10142-025-01587-0
[8]  Blond, E., Disse, E., Cuerq, C., Drai, J., Valette, P., Laville, M., et al. (2017) EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease in Severely Obese People: Do They Lead to Over-Referral? Diabetologia, 60, 1218-1222.
https://doi.org/10.1007/s00125-017-4264-9
[9]  Ahoui-Apendi, C., Itoua-Ngaporo, N.A., Mongo-Onkouo, A., Merveille, M.M., Mimiesse, J.F., Bahamognoua, N.A., et al. (2020) Hepatic Steatosis in Patients with Metabolic Syndrome at the Brazzaville University Hospital Center. Open Journal of Gastroenterology, 10, 119-127.
https://doi.org/10.4236/ojgas.2020.106012
[10]  Elilie Mawa Ongoth, F., Mimiesse, J.F., Fantore, D.L., et al. (2023) Evaluation non invasive de la stéatose hépatique chez le patient diabétique de type 2 à Brazzaville: Intérêt du Fibroscan. Journal de la société de biologie clinique du Bénin, 44, 63-67.
[11]  Alberti, K.G.M.M., Eckel, R.H., Grundy, S.M., Zimmet, P.Z., Cleeman, J.I., Donato, K.A., et al. (2009) Harmonizing the Metabolic Syndrome: A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120, 1640-1645.
https://doi.org/10.1161/circulationaha.109.192644
[12]  Karlas, T., Petroff, D., Garnov, N., Böhm, S., Tenckhoff, H., Wittekind, C., et al. (2014) Non-invasive Assessment of Hepatic Steatosis in Patients with NAFLD Using Controlled Attenuation Parameter and 1H-MR Spectroscopy. PLOS ONE, 9, e91987.
https://doi.org/10.1371/journal.pone.0091987
[13]  Boursier, J., Guillaume, M., Bouzbib, C., Lannes, A., Pais, R., Smatti, S., et al. (2022) Non-Invasive Diagnosis and Follow-Up of Non-Alcoholic Fatty Liver Disease. Clinics and Research in Hepatology and Gastroenterology, 46, Article ID: 101769.
https://doi.org/10.1016/j.clinre.2021.101769
[14]  Mellemkjær, A., Kjær, M.B., Haldrup, D., Grønbæk, H. and Thomsen, K.L. (2024) Management of Cardiovascular Risk in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease. European Journal of Internal Medicine, 122, 28-34.
https://doi.org/10.1016/j.ejim.2023.11.012
[15]  Kouamé, H.G.D., Doffou, A.S., Koffi, K.O.C., et al. (2024) Facteurs Associés à la Stéatopathie Métabolique Hépatique Diagnostiquée par le Fibroscan/CAP chez le Sujet Diabétique de Type 2 en Côte d’Ivoire. Health Sciences and Diseases, 25, 37-41.
[16]  Fedala, N.S., Haddam, A.E.M., Meskine, D. and Chentli, F. (2013) La stéatose hépatique dans le diabète sucré de type 2. Annales d’Endocrinologie, 74, 388.
https://doi.org/10.1016/j.ando.2013.07.523
[17]  Ajmera, V., Cepin, S., Tesfai, K., Hofflich, H., Cadman, K., Lopez, S., et al. (2023) A Prospective Study on the Prevalence of NAFLD, Advanced Fibrosis, Cirrhosis and Hepatocellular Carcinoma in People with Type 2 Diabetes. Journal of Hepatology, 78, 471-478.
https://doi.org/10.1016/j.jhep.2022.11.010
[18]  Halloul, I., Ben Abdelkerim, A., Hammami, E., Ach, M.T., Saad, G., Maaroufi, A., et al. (2021) Intrication du déséquilibre chronique du diabète dans la majoration du risque de fibrose hépatique. Annales d’Endocrinologie, 82, 484.
https://doi.org/10.1016/j.ando.2021.08.672
[19]  Hickman, I.J., Russell, A.J., Prins, J.B. and Macdonald, G.A. (2008) Should Patients with Type 2 Diabetes and Raised Liver Enzymes Be Referred for Further Evaluation of Liver Disease? Diabetes Research and Clinical Practice, 80, e10-e12.
https://doi.org/10.1016/j.diabres.2007.11.016
[20]  Mandal, A., Bhattarai, B., Kafle, P., Khalid, M., Jonnadula, S.K., Lamicchane, J., et al. (2018) Elevated Liver Enzymes in Patients with Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease. Cureus, 10, e3626.
https://doi.org/10.7759/cureus.3626
[21]  Targher, G., Corey, K.E., Byrne, C.D. and Roden, M. (2021) The Complex Link between NAFLD and Type 2 Diabetes Mellitus—Mechanisms and Treatments. Nature Reviews Gastroenterology & Hepatology, 18, 599-612.
https://doi.org/10.1038/s41575-021-00448-y
[22]  Marty, M., de Ledinghen, V., Vergniol, J., Foucher, J., Gonzalez, C., Maury, E., et al. (2014) P203 Fibrose hépatique chez les patients diabétiques: Rôles de la stéatose et de l’accumulation de produits de glycation avancée. Diabetes & Metabolism, 40, A76.
https://doi.org/10.1016/s1262-3636(14)72494-2
[23]  Gonzalez, C., Rigalleau, V., Maury, E., Gin, H., Beauvieux, M., Vergniol, J., et al. (2011) P180—Dépistage non invasif de la fibrose hépatique chez les patients diabétiques hospitalisés. Diabetes & Metabolism, 37, A77.
https://doi.org/10.1016/s1262-3636(11)70806-0
[24]  Eloillaf, M., Mrabet, S., Saad, G., Harbi, R., Gasmi, A., Ben Jezia, E., et al. (2024) Prévalence et facteurs associées à une fibrose hépatique significative chez les diabétiques types 2. Annales d’Endocrinologie, 85, 537.
https://doi.org/10.1016/j.ando.2024.08.510
[25]  Chan, W., Chuah, K., Rajaram, R.B., Lim, L., Ratnasingam, J. and Vethakkan, S.R. (2023) Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-Of-The-Art Review. Journal of Obesity & Metabolic Syndrome, 32, 197-213.
https://doi.org/10.7570/jomes23052
[26]  Rakusanova, S. and Cajka, T. (2024) Metabolomics and Lipidomics for Studying Metabolic Syndrome: Insights into Cardiovascular Diseases, Type 1 & 2 Diabetes, and Metabolic Dysfunction-Associated Steatotic Liver Disease. Physiological Research, 73, S165-S183.
https://doi.org/10.33549/physiolres.935443
[27]  Juanola, O., Martínez-López, S., Francés, R. and Gómez-Hurtado, I. (2021) Non-alcoholic Fatty Liver Disease: Metabolic, Genetic, Epigenetic and Environmental Risk Factors. International Journal of Environmental Research and Public Health, 18, Article 5227.
https://doi.org/10.3390/ijerph18105227
[28]  Schreiner, A.D., Zhang, J., Durkalski‐Mauldin, V., Livingston, S., Marsden, J., Bian, J., et al. (2021) Advanced Liver Fibrosis and the Metabolic Syndrome in a Primary Care Setting. Diabetes/Metabolism Research and Reviews, 37, e3452.
https://doi.org/10.1002/dmrr.3452
[29]  Zhang, W., Song, W.J., Chen, W., Pan, Z., Zhang, J., Fan, L., et al. (2024) Metabolic Dysfunction-Associated Steatotic Liver Disease-Related Hepatic Fibrosis Increases Risk of Insulin Resistance, Type 2 Diabetes, and Chronic Kidney Disease. European Journal of Gastroenterology & Hepatology, 36, 802-810.
https://doi.org/10.1097/meg.0000000000002767
[30]  Tana, C., Ballestri, S., Ricci, F., Di Vincenzo, A., Ticinesi, A., Gallina, S., et al. (2019) Cardiovascular Risk in Non-Alcoholic Fatty Liver Disease: Mechanisms and Therapeutic Implications. International Journal of Environmental Research and Public Health, 16, Article 3104.
https://doi.org/10.3390/ijerph16173104
[31]  Ryysy, L., Häkkinen, A.M., Goto, T., Vehkavaara, S., Westerbacka, J., Halavaara, J., et al. (2000) Hepatic Fat Content and Insulin Action on Free Fatty Acids and Glucose Metabolism Rather than Insulin Absorption Are Associated with Insulin Requirements during Insulin Therapy in Type 2 Diabetic Patients. Diabetes, 49, 749-758.
https://doi.org/10.2337/diabetes.49.5.749
[32]  Trivedi, H.D., Tran, Q., Fricker, Z., Curry, M.P., Li, J.X. and Lai, M. (2023) Type 2 Diabetes Complications Are Associated with Liver Fibrosis Independent of Hemoglobin A1c. Annals of Hepatology, 28, Article ID: 101087.
https://doi.org/10.1016/j.aohep.2023.101087
[33]  Bril, F., Berg, G., Barchuk, M. and Nogueira, J.P. (2025) Practical Approaches to Managing Dyslipidemia in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease. Journal of Lipid and Atherosclerosis, 14, 5-29.
https://doi.org/10.12997/jla.2025.14.1.5
[34]  Ono, H., Atsukawa, M., Tsubota, A., Arai, T., Suzuki, K., Higashi, T., et al. (2024) Impact of Pemafibrate in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease Complicated by Dyslipidemia: A Single-Arm Prospective Study. JGH Open, 8, e13057.
https://doi.org/10.1002/jgh3.13057
[35]  Tanase, D.M., Gosav, E.M., Costea, C.F., Ciocoiu, M., Lacatusu, C.M., Maranduca, M.A., et al. (2020) The Intricate Relationship between Type 2 Diabetes Mellitus (T2DM), Insulin Resistance (IR), and Non-Alcoholic Fatty Liver Disease (NAFLD). Journal of Diabetes Research, 2020, Article ID: 3920196.
https://doi.org/10.1155/2020/3920196

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133