High prevalence of undiagnosed liver cirrhosis and advanced fibrosis in type 2 diabetic patients

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Cryostat sections were analyzed immunohistochemically. A and B. CTLA4Ig and IDO expressions were positive in liver tissues in the CTLA4Ig-IDO group on day 14 after gene transfer (DAB staining, original magnification x 200). C. Liver grafts in the control group lacked detectable CTLA4Ig and IDO expressions." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Yakun Wu, Zheng Yu, Junhua Gong, Min Li, Yiming Liu, Jianping Gong" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Yakun" "apellidos" => "Wu" ] 1 => array:2 [ "nombre" => "Zheng" "apellidos" => "Yu" ] 2 => array:2 [ "nombre" => "Junhua" "apellidos" => "Gong" ] 3 => array:2 [ "nombre" => "Min" "apellidos" => "Li" ] 4 => array:2 [ "nombre" => "Yiming" "apellidos" => "Liu" ] 5 => array:2 [ "nombre" => "Jianping" "apellidos" => "Gong" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268119306350?idApp=UINPBA00004N" "url" => "/16652681/0000001500000005/v1_201905310950/S1665268119306350/v1_201905310950/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1665268119306337" "issn" => "16652681" "doi" => "10.5604/16652681.1212431" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "70454" "copyright" => "Fundación Clínica Médica Sur, A.C." 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Sensitivity represents true-positive results, and 1-specificity, false-positive results. The best cutoff point of TyG index for identify simple steatosis and NASH were 4.58 and 4.59, respectively, which showed the highest sensitivity and specifcity." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis E. Simental-Mendía, Esteban Simental-Mendía, Heriberto Rodríguez-Hernández, Martha Rodríguez-Morán, Fernando Guerrero-Romero" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Luis E." "apellidos" => "Simental-Mendía" ] 1 => array:2 [ "nombre" => "Esteban" "apellidos" => "Simental-Mendía" ] 2 => array:2 [ "nombre" => "Heriberto" "apellidos" => "Rodríguez-Hernández" ] 3 => array:2 [ "nombre" => "Martha" "apellidos" => "Rodríguez-Morán" ] 4 => array:2 [ "nombre" => "Fernando" "apellidos" => "Guerrero-Romero" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268119306337?idApp=UINPBA00004N" "url" => "/16652681/0000001500000005/v1_201905310950/S1665268119306337/v1_201905310950/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "titulo" => "High prevalence of undiagnosed liver cirrhosis and advanced fibrosis in type 2 diabetic patients" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "721" "paginaFinal" => "728" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Juan P. Arab, Francisco Barrera, Consuelo Gallego, Juan P. Valderas, Sergio Uribe, Cristian Tejos, Cristóbal Serrano, Álvaro Huete, Jessica Liberona, Pilar Labbé, Teresa Quiroga, Carlos Benítez, Pablo Irarrázaval, Arnoldo Riquelme, Marco Arrese" "autores" => array:15 [ 0 => array:3 [ "nombre" => "Juan P." "apellidos" => "Arab" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Francisco" "apellidos" => "Barrera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Consuelo" "apellidos" => "Gallego" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "†" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Juan P." "apellidos" => "Valderas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "†" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Sergio" "apellidos" => "Uribe" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "‡" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "Cristian" "apellidos" => "Tejos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "||" "identificador" => "aff0025" ] ] ] 6 => array:3 [ "nombre" => "Cristóbal" "apellidos" => "Serrano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "‡" "identificador" => "aff0015" ] ] ] 7 => array:3 [ "nombre" => "Álvaro" "apellidos" => "Huete" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "‡" "identificador" => "aff0015" ] ] ] 8 => array:3 [ "nombre" => "Jessica" "apellidos" => "Liberona" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "†" "identificador" => "aff0010" ] ] ] 9 => array:3 [ "nombre" => "Pilar" "apellidos" => "Labbé" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 10 => array:3 [ "nombre" => "Teresa" "apellidos" => "Quiroga" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "§" "identificador" => "aff0020" ] ] ] 11 => array:3 [ "nombre" => "Carlos" "apellidos" => "Benítez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 12 => array:3 [ "nombre" => "Pablo" "apellidos" => "Irarrázaval" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "||" "identificador" => "aff0025" ] ] ] 13 => array:3 [ "nombre" => "Arnoldo" "apellidos" => "Riquelme" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 14 => array:4 [ "nombre" => "Marco" "apellidos" => "Arrese" "email" => array:1 [ 0 => "marrese@med.puc.cl" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Departamento de Gastroenterología, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile" "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Nutrición, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile" "etiqueta" => "†" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Radiología, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile" "etiqueta" => "‡" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Laboratorio Clínico, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile" "etiqueta" => "§" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Escuela de Medicina and Departamento de Ingeniería Eléctrica, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile" "etiqueta" => "||" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondence and reprint request:" ] ] ] ] "textoCompleto" => "IntroductionDiabetes mellitus is one of the most prevalent chronic diseases, with an estimated prevalence of 8.3% of the world’s adult population and currently represent the 7th leading cause of death in the United States,<a class="elsevierStyleCrossRef" href="#bib0005">1</a> which represent a significant health burden due to diabetes-associated complications. Liver disease is a relevant cause of morbidity and mortality in type 2 diabetes mellitus (T2DM).<a class="elsevierStyleCrossRef" href="#bib0010">2</a> Diabetic patients are at higher risk of developing cirrhosis and liver failure.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> However liver disease remains a neglected end organ complication of diabetes.Chronic liver disease in T2DM patients is mostly attributable to Non-Alcoholic Fatty Liver Disease (NAFLD).<a class="elsevierStyleCrossRef" href="#bib0020">4</a> NAFLD refers to a clinicopathological entity that comprehends a liver disease spectrum spanning from bland hepatic steatosis to non-alcoholic steatohepatitis (NASH) with the latter being a more aggressive form of the disease which ultimately leads to fibrosis, cirrhosis and hepatocellular carcinoma (HCC).<a class="elsevierStyleCrossRef" href="#bib0025">5</a> The estimated prevalence of NAFLD in T2DM patients ranges between 42–70% in ultrasound-based large scale population studies<a class="elsevierStyleCrossRef" href="#bib0030">6</a> which doubles the NAFLD prevalence figures found in the general population.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> Moreover, T2DM is a strong predictor of the presence of NASH and liver fibrosis in NAFLD patients.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> Even diabetic subjects with normal aminotransferases exhibit a high prevalence NAFLD and NASH (76% and 56% respectively) as recently shown by Portillo-Sánchez, et al.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> Thus, T2DM patients seem to have higher prevalence and severity of NAFLD.<a class="elsevierStyleCrossRef" href="#bib0045">9</a>In the NAFLD field, the identification of patients with advanced fibrosis or cirrhosis has been focus of intense research. Although liver biopsy is still the gold standard for NASH and liver fibrosis diagnosis, the associated costs and potential adverse events precludes its use as a surveillance method to detect NAFLD in general population.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> A wide number of non-invasive biomarkers have been validated for assessing the severity of liver fibrosis in NAFLD.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> One of the most extensively validated scores is the NAFLD fibrosis score (NFS), which accurately predicts NAFLD patients with advanced fibrosis<a class="elsevierStyleCrossRef" href="#bib0060">12</a>,<a class="elsevierStyleCrossRef" href="#bib0065">13</a> and is recommended for non-invasive assessment in current AASLD and EASL guidelines.<a class="elsevierStyleCrossRef" href="#bib0055">11</a>,<a class="elsevierStyleCrossRef" href="#bib0070">14</a> A metanalysis of thirteen studies (n = 3064) estimated the AUROC, sensitivity and specificity of NFS on predicting advanced fibrosis was 0.85 (0.80-0.93), 0.90 (0.82-0.99) and 0.97 (0.94-0.99).<a class="elsevierStyleCrossRef" href="#bib0075">15</a> NFS has also been validated in Latin-American population.<a class="elsevierStyleCrossRef" href="#bib0080">16</a>The diagnosis of advanced liver fibrosis and cirrhosis in T2DM patients has important implications, since it enables high-risk patients to undergo esophageal varices and HCC surveillance. However, data on the prevalence of advanced liver disease in T2DM is still scarce. Therefore, the aim of this study was to assess the frequency of advanced liver disease among T2DM patients using non-invasive surveillance approach. For this purpose we evaluated the prevalence of steatosis, advanced fibrosis and cirrhosis in an otherwise unselected > 55 years-old T2DM patients population using the NFS and magnetic resonance imaging (MRI).Material and MethodsPatient populationWe asked for diabetologists and family physicians to invite their diabetic patients older than 55 years old for liver disease surveillance assessment. After referral, patients were evaluated by our team and enrolled if they met the following inclusion criteria:<ul class="elsevierStyleList" id="l0005"><li class="elsevierStyleListItem" id="u0005">•Presence of type 2 diabetes mellitus.</li><li class="elsevierStyleListItem" id="u0010">•Being > 55 years-old.</li><li class="elsevierStyleListItem" id="u0015">•No history of liver disease.</li><li class="elsevierStyleListItem" id="u0020">•Alcohol consumption < 20 g/day in women and < 30 g/day in men.</li><li class="elsevierStyleListItem" id="u0025">•No use of hepatotoxic drugs (over 4 g/day of acetaminophen, methotrexate, nitrofurantoin, and rifampicin).</li><li class="elsevierStyleListItem" id="u0030">•Agree and sign the informed consent form in agreement with the ethical guidelines of the 1975 Declaration of Helsinki.</li></ul>The study was approved by the Pontificia Universidad Católica de Chile Human Research Committee.Clinical examination and liver assessmentFor all patients, clinical and biochemical parameters were determined at baseline. Clinical parameters included height and weight measurements, body mass index (BMI), blood pressure, hypertension and dyslipidemia history, alcohol use (g/day), duration of diabetes, relatives with diabetes, microvascular complications (retinopathy, nephropathy and neuropathy), and macrovascular complications (myocardial infarction, stroke or revascularization). Alcohol consumption was estimated by an experienced interviewer (Physician, MSc Clinical nutrition), who estimated it based on alcohol degrees (percentage of alcohol per total volume) and amount of alcohol consumed. Subjects that consumed one drink per month or less were considered as no alcohol drinkers.Biochemical parameters measured included the following: liver chemistry (including serum levels of aspartate aminotransferase [AST], alanine aminotransferase [ALT], alkaline phosphatase, gammaglutamyl transpeptidase [GGT] and total bilirubin), fasting glucose, fasting serum insulin, glycated hemoglobin A1c (HbA1c), lipid profile and complete blood count. On insulin requiring patients, fasting serum insulin was not measured. Homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated according to the standard formula.<a class="elsevierStyleCrossRef" href="#bib0040">8</a>NFS was calculated as described in Angulo, et al.<a class="elsevierStyleCrossRef" href="#bib0060">12</a> Anthropometry was assessment was also included (height, weight and waist circumference). Metabolic syndrome was diagnosed based on ATP III criteria.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> All patients had no markers of infection by hepatitis B or C viruses.Magnetic resonance imaging were performed using a Philips Intera® 1.5T system (Achieva, Philips, Best, The Netherlands). The MR protocol included the following sequences: T2 with fat saturation, T1 gradient echo, half-Fourier single-shot turbo spin echo, inphase and out-of phase sequences. Liver steatosis was graduated in MRI using a gradient echo sequence employing the IDEAL method<a class="elsevierStyleCrossRef" href="#bib0090">18</a> and categorized as it follows: 1: mild, 2: moderate and 3: severe.The presence of liver cirrhosis in MRI was assessed using conventional morphological criteria such as enlarged caudate lobe and left lobe lateral segment (segments II and III) with concomitant atrophy of the posterior segments (VI and VII) of the right lobe, enlargement of hiliar portal space, nodular surface of the liver and increased spleen diameter.<a class="elsevierStyleCrossRefs" href="#bib0095">19</a>-<a class="elsevierStyleCrossRef" href="#bib0105">21</a> Liver biopsy was offered to selected patients based on current recommendations.<a class="elsevierStyleCrossRef" href="#bib0110">22</a>,<a class="elsevierStyleCrossRef" href="#bib0115">23</a>Based on the available data patients were classified in one of the following categories:<ul class="elsevierStyleList" id="l0010"><li class="elsevierStyleListItem" id="u0035">•No evidence of liver disease.</li><li class="elsevierStyleListItem" id="u0040">•As having steatosis if steatosis was present on imaging studies.</li><li class="elsevierStyleListItem" id="u0045">•As having advanced liver fibrosis if the NFS value was over 0,675.</li><li class="elsevierStyleListItem" id="u0050">•As having cirrhosis based on the liver morphology on MRI.</li></ul>Data analysisClinical and biochemical variables are presented as mean ± standard deviation (SD) for continuous data with normal distribution. Median (Q1–Q3) for those variables without normal distribution and as percentage for categorical data. Clinical data were analyzed employing χ<a class="elsevierStyleCrossRef" href="#bib0010">2</a> test for categorical variables and Student t-test for continuous variables following a normal distribution. Variables without normal distribution were analyzed by using MannWhitney U test. Receiver-operating characteristic (ROC) curves were used to obtain a cut-off value when the area under the curve was larger than 60%. Based on ROC curve cut-off values, continuous variables were transformed into discrete ones. Univariate and multivariate analyses were performed. Potential clinical and biochemical variables associated with advanced liver fibrosis were examined by comparing the means and proportions of variables among people with or without advanced liver fibrosis. To study these relationships further, univariate analysis was performed using χ<a class="elsevierStyleCrossRef" href="#bib0010">2</a> test for categorical variables and Student t-test for continuous variables. In order to identify independent variables associated with advanced liver fibrosis, a stepwise procedure for a multivariate logistic regression analysis was conducted, which included variables that appeared significant in univariate analysis. Log transformation was performed for variables not normally distributed. Variables involved in the estimation of NFS were excluded to avoid multicollinearity. The χ trend test was performed to evaluate possible statistical tendencies for the additive value of variables found to be significant in multivariate analysis. Analyses were performed using IBM SPSS Statistics 20 version software (Chicago, IL). Odds ratio (OR) and 95% confidence intervals (CI) were calculated. Differences were considered significant when P-values < 0.05.ResultsGeneral features of patientsA total of 145 patients were enrolled between March 2011 and April 2014. One hundred thirty-six patients agreed to undergo an abdomen MRI and were evaluated for anthropometry, clinical and laboratory measurements. Three patients did not attend to MRI evaluation; hence 133 patients underwent MRI assessment. The general features of enrolled patients are shown in <a class="elsevierStyleCrossRef" href="#t0005">table 1</a>. 52.6% were women, the median age was 60 years old (57-64), the mean BMI was 29.6 ± 4.7 kg/m<a class="elsevierStyleCrossRef" href="#bib0010">2</a>, the mean diabetes duration since diagnosis was 7.6 ± 6.9 years and the median HbA1c levels was 6.9% (6.3–7.9) [52 mmol/mol (45-63)]. Of note, 66.7% of patients met the criteria for metabolic syndrome, 10.5% had history of macrovascular complications, and the median HOMA-IR was 3.9 (2.7–6.2).<elsevierMultimedia ident="t0005"></elsevierMultimedia>Prevalence of liver diseaseOf the 133 patients studied 43 (32.3%) showed no evidence of liver disease. Ninety-three patients had abnormal findings including 85 (63.9%) with radiological steatosis and 8 (6.0%) with evidence of cirrhosis in the abdominal MRI. Seventeen patients (12.8%) of the group had a NFS > 0.675 suggesting the presence of advanced liver fibrosis. Only one subject agreed to have liver biopsy because of persistently elevated liver tests. She was classified as liver steatosis without cirrhosis on MRI analysis and advanced fibrosis by NFS on non-invasive assessment. Liver biopsy demonstrated NASH with stage 3 fibrosis.Variables associated to advanced liver fibrosisVariables associated to advanced liver fibrosis or cirrhosis in a univariate analysis are shown in <a class="elsevierStyleCrossRef" href="#t0010">table 2</a>. Daily alcohol consumption, serum levels of GGT, platelet count and albumin were associated with the presence of advanced liver disease. Notably, when a cut off on GGT level was established we were able to improve its discriminative power (AUC 0.728, 95% CI 0.604-0.852, p = 0.002, sensibility 35%, specificity 93%) (<a class="elsevierStyleCrossRef" href="#t0010">Table 2</a>). A multivariate analysis showed that a GGT > 82 IU/L and no alcohol consumption were independently related to advanced fibrosis, as is shown in <a class="elsevierStyleCrossRef" href="#t0015">table 3</a>.<elsevierMultimedia ident="t0010"></elsevierMultimedia><elsevierMultimedia ident="t0015"></elsevierMultimedia>DiscussionThe issue of detecting liver disease in diabetics is relevant since cirrhosis is a significant cause of morbidity and mortality in this patient population<a class="elsevierStyleCrossRef" href="#bib0015">3</a> and this end-organ damage is frequently overlooked in the primary care setting.<a class="elsevierStyleCrossRef" href="#bib0120">24</a> In the present study we used a non-invasive surveillance approach for detecting liver disease in unselected diabetic patients older than 55 years-old. Considering our inclusion criteria, liver alterations found in our assessment are more likely to be related to NAFLD.<a class="elsevierStyleCrossRef" href="#bib0125">25</a> The frequency of steatosis (63.9%) see in our T2DM patients is similar to figures found in two recent reports conducted in primary care setting that used magnetic resonance spectroscopy and MRI assessment respectively.<a class="elsevierStyleCrossRef" href="#bib0040">8</a>,<a class="elsevierStyleCrossRef" href="#bib0130">26</a> Previous data on NAFLD prevalence in diabetic patients is mostly ultrasound-based and included patients of different ages.<a class="elsevierStyleCrossRef" href="#bib0135">27</a> In our study we selected T2DM patients with > 55 years old, and used an MRI based diagnosis of steatosis which is a more sensitive diagnostic test. Hence, the prevalence of NAFLD was within the higher end of previous reports and in agreement with the recent report by Doycheva, et al.<a class="elsevierStyleCrossRef" href="#bib0130">26</a> (65%) that used MRI for steatosis assessment. A more recent report that screened diabetic patients using a novel ultrasound-based technique (controlled attenuation parameter) to detect NAFLD found that 72.8% of subjects had evidence of steatosis, which is also consistent with our findings.<a class="elsevierStyleCrossRef" href="#bib0140">28</a> Noteworthy, we found a significant proportion of diabetic patients with evidence of advanced liver disease including those with significant liver fibrosis (12.8%) and undiagnosed liver cirrhosis (6.0%). These figures are also in agreement with the recent report by Doycheva, et al. that enrolled 100 consecutive patients with T2DM (mean age 59.7 and BMI 30.8 kg/m<a class="elsevierStyleCrossRef" href="#bib0010">2</a> without liver disease) and found that advanced liver fibrosis (as assessed by MRI elastography) in 7.1% of their patients<a class="elsevierStyleCrossRef" href="#bib0130">26</a> and with the report by Kwok, et al. that, using liver stiffness measurements, found that 17.7% of diabetics had significant liver fibrosis.<a class="elsevierStyleCrossRef" href="#bib0140">28</a> When compared with the general population, the frequency of advanced liver fibrosis (significant fibrosis and cirrhosis) in T2DM patients seems to be significantly higher although the information on prevalence of, and variables associated with, liver fibrosis in general population is scarce. Some authors have roughly estimated the prevalence of liver cirrhosis in 1% of the general population using transient elastography based diagnosis,<a class="elsevierStyleCrossRef" href="#bib0145">29</a> but data is limited. The recent study of Koehler, et al.,<a class="elsevierStyleCrossRef" href="#bib0150">30</a> a population-based study among subjects > 45 years, found a 5.6% of the individuals with clinically relevant liver fibrosis assessed by liver stiffness measurement. Interestingly, in this study diabetes was strongly associated with liver fibrosis confirming that this subgroup of individuals is at risk of liver disease. Collectively, the available data including that of the present study, give support to the concept that advanced liver disease, likely secondary to progressive NAFLD, is an important and under-recognized condition in T2DM patients and that awareness about this issue among health care providers of diabetic patients should be improved in order to increase the detection of patients at risk of developing or having liver fibrosis/cirrhosis and prevent their complications.In our study, the multivariate analysis showed that serum levels of GGT and absence of alcohol consumption were independently associated with advanced fibrosis assessed by NFS. The association between liver fibrosis and elevated GGT is in line with prior studies.<a class="elsevierStyleCrossRefs" href="#bib0155">31</a>–<a class="elsevierStyleCrossRef" href="#bib0165">33</a> Hence, serum levels of GGT may have value in detecting significant fibrosis in diabetic subjects. As for the potential protective role of moderate alcohol intake in NAFLD, this has been previously reported in nondiabetic subjects.<a class="elsevierStyleCrossRefs" href="#bib0170">34</a>–<a class="elsevierStyleCrossRef" href="#bib0190">38</a> The mechanisms that explain this protective effect of alcohol consumption on NAFLD are unknown; however, it can be related to the anti-oxidant effects of some alcoholic beverages, such as red wine, that can reduce reactive oxygen species and reduce cell damage in the setting of NASH. Patients who consume alcohol have increased circulating adiponectin, which has a protective role in NAFLD mediated through adenosine monophosphate-activated protein kinase and peroxisome proliferator-activated receptor a enhanced by activation of adiponectin receptor 2 in hepatocytes.<a class="elsevierStyleCrossRef" href="#bib0195">39</a> Importantly, we do not recommend to promote drinking habits in NAFLD patients (evidence 1B, AASLD guidelines), however there is no evidence to completely stop alcohol in NAFLD patients with non-significant drinking habits as our data support a potential protective effect.As in previous reports, the main limitation of the present study is the absence of liver histology assessment. Since many patients and physicians are reluctant to perform or undergo liver biopsy due to associated health costs and potential adverse events, this study was designed to use a non-invasive approach to determine the prevalence of liver disease and cirrhosis in unselected diabetic patients older than 55 years-old taken into account the fact that liver fibrosis increases with age in NAFLD, which has been recently shown also in diabetics.<a class="elsevierStyleCrossRef" href="#bib0130">26</a> Regarding liver fibrosis, we used the most extensively validated score (NFS), recommended in most of current guidelines NAFLD for non-invasive liver fibrosis assessment.<a class="elsevierStyleCrossRef" href="#bib0050">10</a>,<a class="elsevierStyleCrossRef" href="#bib0200">40</a> However data on validation of these scores in diabetic population is scarce and there is no consensus in cut-off values. In addition, 75 subjects presented indeterminate NFS, many of them might present advanced fibrosis if they undergo histology assessment. Based on these facts, we believe our surveillance approach is likely to underestimate the prevalence of advanced liver fibrosis. Regarding liver cirrhosis diagnosis, we selected the morphological features that have been described to have a high sensitivity (87-93%) and specificity (92%) for cirrhosis diagnosis.<a class="elsevierStyleCrossRef" href="#bib0100">20</a>,<a class="elsevierStyleCrossRef" href="#bib0105">21</a> Another limitation of our study is the possibility of selection bias on the referral; however patients were consecutively invited directly on diabetes and family medicine clinics and referred to our team. In spite of the limitations of our non-invasive diagnosis, we observed that our estimate of advanced liver disease (12.8% of significant fibrosis plus 6% cirrhosis) is in agreement with findings using other techniques such as MRI elastography<a class="elsevierStyleCrossRef" href="#bib0130">26</a> and vibration controlled transient elastography.<a class="elsevierStyleCrossRef" href="#bib0140">28</a>Current diabetes society guidelines<a class="elsevierStyleCrossRef" href="#bib0205">41</a> do not provide specific recommendations for liver assessment in diabetic patients. We believe that our data and that of other recent studies<a class="elsevierStyleCrossRef" href="#bib0130">26</a>,<a class="elsevierStyleCrossRef" href="#bib0140">28</a> strongly suggest that patients with T2DM may benefit from screening of liver fibrosis.<a class="elsevierStyleCrossRef" href="#bib0120">24</a> The early diagnosis of significant fibrosis would give the opportunity for lifestyle and pharmacologic intervention to prevent further progression of liver disease which would be meaningful in the context of emerging therapies for NAFLD.<a class="elsevierStyleCrossRef" href="#bib0210">42</a> However, even more important is the early diagnosis of liver cirrhosis, since patients with this condition would benefit of esophageal varices and HCC surveillance. Timely diagnosis will enable the implementation of primary prophylaxis for variceal bleeding and/or curative treatment for early HCC if detected. The best strategy to screen T2DM for liver fibrosis remains to be established but current non-invasive tests for evaluation of liver disease severity and prognosis guidelines suggest that NFS and transient elastography are good options.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> Further research is needed to confirm the cost-effectiveness of this approach and to better define both the natural history of NAFLD in T2DM and the effect of novel treatments on it.ConclusionThe present study shows that T2DM patients have significant rates of NAFLD, advanced liver fibrosis and cirrhosis. Screening of these conditions using non-invasive tests may be warranted after validation in larger prospective studies.Abbreviations<ul class="elsevierStyleList" id="l0015"><li class="elsevierStyleListItem" id="u0055">•ALT: alanine aminotransferase.</li><li class="elsevierStyleListItem" id="u0060">•AST: aspartate aminotransferase.</li><li class="elsevierStyleListItem" id="u0065">•BMI: body mass index.</li><li class="elsevierStyleListItem" id="u0070">•GGT: gamma-glutamyl transpeptidase.</li><li class="elsevierStyleListItem" id="u0075">•HCC: hepatocellular carcinoma.</li><li class="elsevierStyleListItem" id="u0080">•MRI: magnetic resonance imaging.</li><li class="elsevierStyleListItem" id="u0085">•NAFLD: Non-Alcoholic Fatty Liver Disease.</li><li class="elsevierStyleListItem" id="u0090">•NASH: Non-Alcoholic Steatohepatitis.</li><li class="elsevierStyleListItem" id="u0095">•NFS: NAFLD fibrosis score.</li><li class="elsevierStyleListItem" id="u0100">•ROC: receiver-operating characteristic.</li><li class="elsevierStyleListItem" id="u0105">•T2DM: type 2 diabetes mellitus.</li></ul>SupportThis study was carried out with support of grants from the Fondo Nacional de Investigación Científica y Tecnológica (FONDECYT 1150327 to M.A. and 1150311 to F.B.) and the Comisión Nacional de Investigación Científica y Tecnológica (grant PIA/Basal PFB12/2007, Basal Centre for Excellence in Science and Technology and ACT79 [to M.A.]) from the Government of Chile. The funding source did not have any role in study design or in data collection, analysis and interpretation.Conflict of InterestsAuthors have no relevant conflict of interest to disclose." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1197989" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abs0010" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1116635" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "s0005" "titulo" => "Introduction" ] 3 => array:3 [ "identificador" => "s0010" "titulo" => "Material and Methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "s0015" "titulo" => "Patient population" ] 1 => array:2 [ "identificador" => "s0020" "titulo" => "Clinical examination and liver assessment" ] 2 => array:2 [ "identificador" => "s0025" "titulo" => "Data analysis" ] ] ] 4 => array:3 [ "identificador" => "s0030" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "s0035" "titulo" => "General features of patients" ] 1 => array:2 [ "identificador" => "s0040" "titulo" => "Prevalence of liver disease" ] 2 => array:2 [ "identificador" => "s0045" "titulo" => "Variables associated to advanced liver fibrosis" ] ] ] 5 => array:2 [ "identificador" => "s0050" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "s0055" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "s0060" "titulo" => "Abbreviations" ] 8 => array:2 [ "identificador" => "s0065" "titulo" => "Support" ] 9 => array:2 [ "identificador" => "s0070" "titulo" => "Conflict of Interests" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-11-30" "fechaAceptado" => "2016-02-09" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1116635" "palabras" => array:8 [ 0 => "NAFLD" 1 => "NASH" 2 => "Fibrosis" 3 => "Diabetes" 4 => "Insulin resistance" 5 => "Obesity" 6 => "Metabolic Syndrome" 7 => "Mortality" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Background. Patients with type 2 diabetes mellitus (T2DM) are at risk for developing end-stage liver disease due to nonalcoholic steatohepatitis (NASH), the aggressive form of non-alcoholic fatty liver disease (NAFLD). Data on prevalence of advanced fibrosis among T2DM patients is scarce. Aim. To evaluate prevalence of steatosis, advanced fibrosis and cirrhosis using non-invasive methods in T2DM patients.Material and methods. 145 consecutive T2DM patients (> 55 years-old) were prospectively recruited. Presence of cirrhosis and advanced fibrosis was evaluated by magnetic resonance imaging (MRI) and NAFLD fibrosis score (NFS) respectively. Exclusion criteria included significant alcohol consumption, markers of viral hepatitis infection or other liver diseases. Results are expressed in percentage or median (interquartile range).Results. 52.6% of patients were women, the median age was 60 years old (57-64), mean BMI was 29.6 ± 4.7 kg/m<a class="elsevierStyleCrossRef" href="#bib0010">2</a> and diabetes duration was 7.6 ± 6.9 years. A high prevalence of liver steatosis (63.9%), advanced fibrosis assessed by NFS (12.8%) and evidence of liver cirrhosis in MRI (6.0%) was observed. In a multivariate analysis GGT > 82 IU/L (P = 0.004) and no alcohol intake (P = 0.032) were independently associated to advanced fibrosis.Conclusion. A high frequency of undiagnosed advanced fibrosis and cirrhosis was observed in non-selected T2DM patients. Screening of these conditions may be warranted in this patient population." ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "t0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "AST: aspartate aminotransferase. ALT: alanine aminotransferase. GGT: gamma-glutamyl transferase. LDL: low-density lipoprotein. HDL: high-density lipoprotein. HOMA-IR: Homeostasis Model Assessment of Insulin Resistance. Results are expressed in median (interquartile range) for variables with abnormal distribution and average ± standard deviation for variables with normal distribution." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n = 133 \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 (57- 64) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63 (47.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dyslipidemia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67 (50.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Waist circumference (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">99.2 ± 10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98.5 ± 11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Metabolic syndrome, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89 (66.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number first relative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">with diabetes, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 (27.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (42.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">> 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (29.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Years of diabetes diagnosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.6 ± 6.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Daily alcohol, g/day \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (0- 14) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0- 2.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Retinopathy history, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (13.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nephropathy history, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (6.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neuropathy history, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (12.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Macrovascular complications, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (10.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AST (IU/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (17- 27.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ALT (IU/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (19- 39) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GGT (IU/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (19- 47.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total bilirubin (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.52 (0.43- 0.69) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alkaline Phosphatase (IU/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 (69- 103) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A lbumin (g/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.5 (4.3- 4.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LDL cholesterol (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90.8 (67- 110.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HDL cholesterol (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46.5 (40- 54.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Triglycerides (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">141 (105- 204.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Glycated hemoglobin A1c, \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.9 (6.3- 7.9) [52 (45-63)] \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">% [mmol/mol] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Platelet count, × 109/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">227 (187- 267) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hematocrit (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.3 ± 3.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">White blood cell count (/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6,857 ± 1,421 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Creatinine (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.8 (0.68- 0.97) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urine albumin/creatinine ratio (pg/mg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.3 (3.8- 17.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HOMA-IR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.9 (2.7- 6.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Body mass index (BMI), (kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.6 ± 4.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NAFLD fibrosis score (NFS) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">> 0.675(F3-4), n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (12.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2045909.png" ] ] ] ] "descripcion" => array:1 [ "en" => "General features of enrolled patients." ] ] 1 => array:7 [ "identificador" => "t0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "GGT: gamma-glutamyl transferase. LDL: low-density lipoprotein. HDL: high-density lipoprotein. HOMA-IR: Homeostasis Model Assessment of Insulin Resistance. p-value obtained by:" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Advanced fibrosis (n = 17) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Absence of advanced fibrosis (n = 116) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 (58 - 68.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 (57- 64) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.103<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (35.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (49.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.286<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hypertension, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (76.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67 (57.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.141<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dyslipidemia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (47.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 (50.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.770<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Waist circumference \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">103.6 ± 8.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98.1 ± 10.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.076<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Metabolic syndrome, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (70.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77 (66.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.835<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number first relative with diabetes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1- 3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0 - 2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.267<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Years of diabetes diagnosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (4- 16.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (2 - 10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.1<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Daily alcohol (g/day) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0- 0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 (0 - 10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.011<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No alcohol consumption, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (82.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (49.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.01<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Retinopathy history, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (14.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.358<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nephropathy history, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (6.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.973<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neuropathy history, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (17.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (12.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.455<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Macrovascular complications, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (11.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (10.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.793<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GGT (IU/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 (31- 135) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (18 - 45.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.003<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GGT > 82 IU/L, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (35.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (6.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0004<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total bilirubin (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.53 (0.43 - 0.62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.51 (0.43 - 0.70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.584<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alkaline phosphatase (IU/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">91 (76.5 - 107.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83.5 (68.3 - 101.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.262<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LDL cholesterol (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96 (79.5 - 108.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87 (66 - 113) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.622<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HDL cholesterol (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (42.5 - 56.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (39 - 54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.471<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Triglycerides (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">144 (136.5 - 207.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">136 (103 - 205) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.407<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Glycated hemoglobin A1c (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.3 (6.1 - 7.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (6.3- 8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.072<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hematocrit (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.2 ± 4.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.5 ± 3.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.754<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">White blood cell count (/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6,611 ± 1,287 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6,829 ± 1,374 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.538<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Platelet count, × 109/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">192 (143.5 - 211.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">234.5 (191.3 - 269.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Albumin (g/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.4 (4.2 - 4.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.5 (4.4 - 4.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Creatinine (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.72 (0.62 - 0.91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.81 (0.68 - 0.97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.142<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urine albumin/creatinine ratio (pg/mg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.8 (4.2 - 21.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.9 (3.7 - 17.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.458<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HOMAIR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.6 (3.1 - 7.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.8 (2.6 - 5.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.283<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">% fat hepatic content \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.7 (33.2 - 45.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36.4 (30.1 - 41.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.209<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2045911.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Mann-Whitney U test;" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "χ2;" ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "t-Student." ] ] ] "descripcion" => array:1 [ "en" => "Variables associated to advanced liver fibrosis. Univariate analysis." ] ] 2 => array:7 [ "identificador" => "t0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "GGT: gamma-glutamyl transferase." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95% Confidence interval \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GGT > 82 IU/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.8-22.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.004 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No alcohol consumption \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.1-16.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.032 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2045910.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Variables associated to advanced liver fibrosis. Multivariate analysis." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bs0010" "bibliografiaReferencia" => array:42 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cost-of-illness studies of diabetes mellitus: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Ng C.S." 1 => "Lee J.Y." 2 => "Toh M.P." 3 => "Ko Y." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.diabres.2014.03.020" "Revista" => array:6 [ "tituloSerie" => "Diabetes Res Clin Pract" "fecha" => "2014" "volumen" => "105" "paginaInicial" => "151" "paginaFinal" => "163" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24814877" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fatty liver disease in diabetes mellitus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Bhatt H.B." 1 => "Smith R.J." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3978/j.issn.2304-3881.2015.01.03" "Revista" => array:7 [ "tituloSerie" => "Hepatobiliary Surg Nutr" "fecha" => "2015" "volumen" => "4" "paginaInicial" => "101" "paginaFinal" => "108" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26005676" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0090429517302881" "estado" => "S300" "issn" => "00904295" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Newly diagnosed diabetes mellitus as a risk factor for serious liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Porepa L." 1 => "Ray J.G." 2 => "Sanchez-Romeu P." 3 => "Booth G.L." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1503/cmaj.092144" "Revista" => array:6 [ "tituloSerie" => "CMAJ" "fecha" => "2010" "volumen" => "182" "paginaInicial" => "E526" "paginaFinal" => "E531" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20566726" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonalcoholic fatty liver disease and diabetes mellitus: pathogenesis and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Smith B.W." 1 => "Adams L.A." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nrendo.2011.72" "Revista" => array:6 [ "tituloSerie" => "Nat Rev Endocrinol" "fecha" => "2011" "volumen" => "7" "paginaInicial" => "456" "paginaFinal" => "465" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21556019" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology and Natural History of Nonalcoholic Fatty Liver Disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Satapathy S.K." 1 => "Sanyal A.J." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0035-1562943" "Revista" => array:6 [ "tituloSerie" => "Semin Liver Dis" "fecha" => "2015" "volumen" => "35" "paginaInicial" => "221" "paginaFinal" => "235" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26378640" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of and risk factors for hepatic steatosis and nonalcoholic Fatty liver disease in people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Williamson R.M." 1 => "Price J.F." 2 => "Glancy S." 3 => "Perry E." 4 => "Nee L.D." 5 => "Hayes P.C." 6 => "Frier B.M." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2337/dc10-2229" "Revista" => array:6 [ "tituloSerie" => "Diabetes Care" "fecha" => "2011" "volumen" => "34" "paginaInicial" => "1139" "paginaFinal" => "1144" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21478462" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic implication of liver histology in patients with nonalcoholic fatty liver disease in diabetes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Doycheva I." 1 => "Patel N." 2 => "Peterson M." 3 => "Loomba R." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jdiacomp.2012.10.008" "Revista" => array:7 [ "tituloSerie" => "J Diabetes Complications" "fecha" => "2013" "volumen" => "27" "paginaInicial" => "293" "paginaFinal" => "300" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23312215" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534708024452" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus and normal plasma aminotransferase levels" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Portillo Sanchez P." 1 => "Bril F." 2 => "Maximos M." 3 => "Lomonaco R." 4 => "Biernacki D." 5 => "Orsak B." 6 => "Subbarayan S." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2015-1966" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2015" "volumen" => "100" "paginaInicial" => "2231" "paginaFinal" => "2238" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25885947" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathophysiology of NASH: perspectives for a targeted treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Marra F." 1 => "Lotersztajn S." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Curr Pharm Des" "fecha" => "2013" "volumen" => "19" "paginaInicial" => "5250" "paginaFinal" => "5269" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23394092" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "From NAFLD in clinical practice to answers from guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Nascimbeni F." 1 => "Pais R." 2 => "Bellentani S." 3 => "Day C.P." 4 => "Ratziu V." 5 => "Loria P." 6 => "Lonardo A." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhep.2013.05.044" "Revista" => array:6 [ "tituloSerie" => "J Hepatol" "fecha" => "2013" "volumen" => "59" "paginaInicial" => "859" "paginaFinal" => "871" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23751754" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "European Association for Study of the Liver, Asociación Latinoamericana para el Estudio del Hígado" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhep.2015.04.006" "Revista" => array:6 [ "tituloSerie" => "J Hepatol" "fecha" => "2015" "volumen" => "63" "paginaInicial" => "237" "paginaFinal" => "264" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25911335" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Angulo P." 1 => "Hui J.M." 2 => "Marchesini G." 3 => "Bugianesi E." 4 => "George J." 5 => "Farrell G.C." 6 => "Enders F." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hep.21496" "Revista" => array:6 [ "tituloSerie" => "Hepatology" "fecha" => "2007" "volumen" => "45" "paginaInicial" => "846" "paginaFinal" => "854" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17393509" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Angulo P." 1 => "Kleiner D.E." 2 => "Dam-Larsen S." 3 => "Adams L.A." 4 => "Bjornsson E.S." 5 => "Charatcharoenwitthaya P." 6 => "Mills P.R." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.gastro.2015.04.043" "Revista" => array:6 [ "tituloSerie" => "Gastroenterology" "fecha" => "2015" "volumen" => "149" "paginaInicial" => "389" "paginaFinal" => "397" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25935633" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Chalasani N." 1 => "Younossi Z." 2 => "Lavine J.E." 3 => "Diehl A.M." 4 => "Brunt E.M." 5 => "Cusi K." 6 => "Charlton M." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hep.25762" "Revista" => array:6 [ "tituloSerie" => "Hepatology" "fecha" => "2012" "volumen" => "55" "paginaInicial" => "2005" "paginaFinal" => "2023" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22488764" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Musso G." 1 => "Gambino R." 2 => "Cassader M." 3 => "Pagano G." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/07853890.2010.518623" "Revista" => array:7 [ "tituloSerie" => "Ann Med" "fecha" => "2011" "volumen" => "43" "paginaInicial" => "617" "paginaFinal" => "649" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21039302" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534716305833" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validation study of systems for noninvasive diagnosis of fibrosis in nonalcoholic fatty liver disease in Latin population" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Pérez-Gutiérrez O.Z." 1 => "Hernández-Rocha C." 2 => "Candia-Balboa R.A." 3 => "Arrese M.A." 4 => "Benítez C." 5 => "Brizuela-Alcántara D.C." 6 => "Méndez-Sánchez N." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Hepatol" "fecha" => "2013" "volumen" => "12" "paginaInicial" => "416" "paginaFinal" => "424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23619258" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Grundy S.M." 1 => "Brewer H.B. Jr" 2 => "Cleeman J.I." 3 => "Smith S.C. Jr" 4 => "Lenfant C." 5 => "American Heart A." 6 => "National Heart L." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.CIR.0000111245.75752.C6" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2004" "volumen" => "109" "paginaInicial" => "433" "paginaFinal" => "438" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14744958" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Water-fat separation with IDEAL gradient-echo imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Reeder S.B." 1 => "McKenzie C.A." 2 => "Pineda A.R." 3 => "Yu H." 4 => "Shimakawa A." 5 => "Brau A.C." 6 => "Hargreaves B.A." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jmri.20831" "Revista" => array:6 [ "tituloSerie" => "J Magn Reson Imaging" "fecha" => "2007" "volumen" => "25" "paginaInicial" => "644" "paginaFinal" => "652" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17326087" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of liver cirrhosis, using diagnostic imaging tools" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Yeom S.K." 1 => "Lee C.H." 2 => "Cha S.H." 3 => "Park C.M." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4254/wjh.v7.i17.2069" "Revista" => array:6 [ "tituloSerie" => "World J Hepatol" "fecha" => "2015" "volumen" => "7" "paginaInicial" => "2069" "paginaFinal" => "2079" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26301049" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enlargement of hilar periportal space: a sign of early cirrhosis at MR imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Ito K." 1 => "Mitchell D.G." 2 => "Gabata T." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Magn Reson Imaging" "fecha" => "2000" "volumen" => "11" "paginaInicial" => "136" "paginaFinal" => "140" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10713945" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-invasive diagnosis of liver cirrhosis: magnetic resonance imaging presents special features" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Numminen K." 1 => "Tervahartiala P." 2 => "Halavaara J." 3 => "Isoniemi H." 4 => "Hockerstedt K." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Scand J Gastroenterol" "fecha" => "2005" "volumen" => "40" "paginaInicial" => "76" "paginaFinal" => "82" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15841718" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recommendations for diagnosis, referral for liver biopsy, and treatment of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Spengler E.K." 1 => "Loomba R." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.mayocp.2015.06.013" "Revista" => array:6 [ "tituloSerie" => "Mayo Clin Proc" "fecha" => "2015" "volumen" => "90" "paginaInicial" => "1233" "paginaFinal" => "1246" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26219858" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recommendations for liver biopsy evaluation in non-alcoholic fatty liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Stinton L.M." 1 => "Loomba R." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Minerva Gastroenterol Dietol" "fecha" => "2014" "volumen" => "60" "paginaInicial" => "5" "paginaFinal" => "13" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24632764" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Liver disease: A neglected complication of diabetes mellitus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Arrese M." 1 => "Arab J.P." 2 => "Arancibia J.P." 3 => "Candia R." 4 => "Riquelme A." 5 => "Barrera F." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "editores" => "BagchiD., SreejayanN." "titulo" => "Nutritional and therapeutic interventions for diabetes and metabolic syndrome" "paginaInicial" => "289" "paginaFinal" => "294" "serieFecha" => "2012" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis of non-alcoholic fatty liver disease (NAFLD)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Yri-Järvinen H." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00125-016-3944-1" "Revista" => array:6 [ "tituloSerie" => "Diabetologia" "fecha" => "2016" "volumen" => "59" "paginaInicial" => "1104" "paginaFinal" => "1111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27091184" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-invasive screening of diabetics in primary care for NAFLD and advanced fibrosis by MRI and MRE" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Doycheva I." 1 => "Cui J." 2 => "Nguyen P." 3 => "Costa E.A." 4 => "Hooker J." 5 => "Hofflich H." 6 => "Bettencourt R." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/apt.13405" "Revista" => array:6 [ "tituloSerie" => "Aliment Pharmacol Ther" "fecha" => "2016" "volumen" => "43" "paginaInicial" => "83" "paginaFinal" => "95" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26369383" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonalcoholic fatty liver disease: liver disease: an overlooked complication of diabetes mellitus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Arrese M." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nrendo.2010.173" "Revista" => array:7 [ "tituloSerie" => "Nat Rev Endocrinol" "fecha" => "2010" "volumen" => "6" "paginaInicial" => "660" "paginaFinal" => "661" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21102646" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283812006161" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Kwok R, Choi KC, Wong GL, Zhang Y, Chan HL, Luk AO, Shu SS, et al. Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: a prospective cohort study. Gut 2015." ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Screening the general population for cirrhosis using transient elastography: finding a needle in a haystack?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Castera L." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/gut.2010.234203" "Revista" => array:6 [ "tituloSerie" => "Gut" "fecha" => "2011" "volumen" => "60" "paginaInicial" => "883" "paginaFinal" => "884" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21471569" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Koehler EM, Plompen EP, Schouten JN, Hansen BE, Darwish Murad S, Taimr P, Leebeek FW, et al. Presence of diabetes mellitus and steatosis is associated with liver stiffness in a general population: The Rotterdam study. Hepatology 2015." ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histopathological stages of nonalcoholic fatty liver disease in type 2 diabetes: prevalences and correlated factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Leite N.C." 1 => "Villela-Nogueira C.A." 2 => "Pannain V.L." 3 => "Bottino A.C." 4 => "Rezende G.F." 5 => "Cardoso C.R." 6 => "Salles G.F." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1478-3231.2011.02482.x" "Revista" => array:6 [ "tituloSerie" => "Liver Int" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "700" "paginaFinal" => "706" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21457442" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serum gamma-glutamyltranspeptidase distinguishes non-alcoholic fatty liver disease at high risk" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Tahan V." 1 => "Canbakan B." 2 => "Balci H." 3 => "Dane F." 4 => "Akin H." 5 => "Can G." 6 => "Hate-mi I." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hepatogastroenterology" "fecha" => "2008" "volumen" => "55" "paginaInicial" => "1433" "paginaFinal" => "1438" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18795706" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0165" "etiqueta" => "33." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical predictors of different grades of nonalcoholic fatty liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Junior W.S." 1 => "Nonino-Borges C.B." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11695-011-0438-6" "Revista" => array:6 [ "tituloSerie" => "Obes Surg" "fecha" => "2012" "volumen" => "22" "paginaInicial" => "248" "paginaFinal" => "252" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21598007" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0170" "etiqueta" => "34." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Hashimoto Y, Hamaguchi M, Kojima T, Ohshima Y, Ohbora A, Kato T, Nakamura N, et al. The modest alcohol consumption reduces the incidence of fatty liver in men; a population based large scale cohort study. J Gastroenterol Hepatol 2014." ] ] ] 34 => array:3 [ "identificador" => "bib0175" "etiqueta" => "35." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Alcohol consumption appears to protect against non-alcoholic fatty liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Moriya A." 1 => "Iwasaki Y." 2 => "Ohguchi S." 3 => "Kayashima E." 4 => "Mitsumune T." 5 => "Taniguchi H." 6 => "Ikeda F." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2036.2010.04520.x" "Revista" => array:6 [ "tituloSerie" => "Aliment Pharmacol Ther" "fecha" => "2011" "volumen" => "33" "paginaInicial" => "378" "paginaFinal" => "388" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21118396" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0180" "etiqueta" => "36." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Modest alcohol consumption is associated with decreased prevalence of steatohepatitis in patients with non-alcoholic fatty liver disease (NAFLD)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Dunn W." 1 => "Sanyal A.J." 2 => "Brunt E.M." 3 => "Unalp-Arida A." 4 => "Donohue M." 5 => "McCullough A.J." 6 => "Schwimmer J.B." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhep.2012.03.024" "Revista" => array:7 [ "tituloSerie" => "J Hepatol" "fecha" => "2012" "volumen" => "57" "paginaInicial" => "384" "paginaFinal" => "391" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22521357" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283810009206" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0185" "etiqueta" => "37." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Moriya A, Iwasaki Y, Ohguchi S, Kayashima E, Mitsumune T, Taniguchi H, Ando M, et al. Roles of alcohol consumption in fatty liver: a longitudinal study. J Hepatol 2014." ] ] ] 37 => array:3 [ "identificador" => "bib0190" "etiqueta" => "38." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Modest wine drinking and decreased prevalence of suspected nonalcoholic fatty liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Dunn W." 1 => "Xu R." 2 => "Schwimmer J.B." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hep.22292" "Revista" => array:6 [ "tituloSerie" => "Hepatology" "fecha" => "2008" "volumen" => "47" "paginaInicial" => "1947" "paginaFinal" => "1954" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18454505" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0195" "etiqueta" => "39." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of adiponectin in the protective action of dietary saturated fat against alcoholic fatty liver in mice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "You M." 1 => "Considine R.V." 2 => "Leone T.C." 3 => "Kelly D.P." 4 => "Crabb D.W." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hep.20821" "Revista" => array:6 [ "tituloSerie" => "Hepatology" "fecha" => "2005" "volumen" => "42" "paginaInicial" => "568" "paginaFinal" => "577" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16108051" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0200" "etiqueta" => "40." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of nonalcoholic fatty liver disease: an evidence-based clinical practice review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "Arab J.P." 1 => "Candia R." 2 => "Zapata R." 3 => "Munoz C." 4 => "Arancibia J.P." 5 => "Poniachik J." 6 => "Soza A." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v20.i34.12182" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol" "fecha" => "2014" "volumen" => "20" "paginaInicial" => "12182" "paginaFinal" => "12201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25232252" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0205" "etiqueta" => "41." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Standards of medical care in diabetes-2014" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "American Diabetes A." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Diab Care" "fecha" => "2014" "volumen" => "37" "numero" => "Suppl. 1" "paginaInicial" => "S14" "paginaFinal" => "S80" ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib0210" "etiqueta" => "42." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pharmacotherapy for Nonalcoholic Fatty Liver Disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Gawrieh S." 1 => "Chalasani N." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0035-1562951" "Revista" => array:7 [ "tituloSerie" => "Semin Liver Dis" "fecha" => "2015" "volumen" => "35" "paginaInicial" => "338" "paginaFinal" => "348" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26378648" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534710000066" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/16652681/0000001500000005/v1_201905310950/S1665268119306349/v1_201905310950/en/main.assets" "Apartado" => array:4 [ "identificador" => "77721" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/16652681/0000001500000005/v1_201905310950/S1665268119306349/v1_201905310950/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268119306349?idApp=UINPBA00004N"]

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Juan P. Arab*, Francisco Barrera*, Consuelo Gallego†, Juan P. Valderas†, Sergio Uribe‡, Cristian Tejos||, Cristóbal Serrano‡, Álvaro Huete‡, Jessica Liberona†, Pilar Labbé*, Teresa Quiroga§, Carlos Benítez*, Pablo Irarrázaval||, Arnoldo Riquelme*, Marco Arrese

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marrese@med.puc.cl

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* Departamento de Gastroenterología, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile

† Departamento de Nutrición, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile

‡ Departamento de Radiología, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile

§ Departamento de Laboratorio Clínico, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile

|| Escuela de Medicina and Departamento de Ingeniería Eléctrica, Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0015">Introduction</span><p id="p0005" class="elsevierStylePara elsevierViewall">Diabetes mellitus is one of the most prevalent chronic diseases&#44; with an estimated prevalence of 8&#46;3&#37; of the world&#8217;s adult population and currently represent the 7th leading cause of death in the United States&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> which represent a significant health burden due to diabetes-associated complications&#46; Liver disease is a relevant cause of morbidity and mortality in type 2 diabetes mellitus &#40;T2DM&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Diabetic patients are at higher risk of developing cirrhosis and liver failure&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However liver disease remains a neglected end organ complication of diabetes&#46;</p><p id="p0010" class="elsevierStylePara elsevierViewall">Chronic liver disease in T2DM patients is mostly attributable to Non-Alcoholic Fatty Liver Disease &#40;NAFLD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> NAFLD refers to a clinicopathological entity that comprehends a liver disease spectrum spanning from bland hepatic steatosis to non-alcoholic steatohepatitis &#40;NASH&#41; with the latter being a more aggressive form of the disease which ultimately leads to fibrosis&#44; cirrhosis and hepatocellular carcinoma &#40;HCC&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The estimated prevalence of NAFLD in T2DM patients ranges between 42&#8211;70&#37; in ultrasound-based large scale population studies<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> which doubles the NAFLD prevalence figures found in the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Moreover&#44; T2DM is a strong predictor of the presence of NASH and liver fibrosis in NAFLD patients&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Even diabetic subjects with normal aminotransferases exhibit a high prevalence NAFLD and NASH &#40;76&#37; and 56&#37; respectively&#41; as recently shown by Portillo-S&#225;nchez&#44; <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Thus&#44; T2DM patients seem to have higher prevalence and severity of NAFLD&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="p0015" class="elsevierStylePara elsevierViewall">In the NAFLD field&#44; the identification of patients with advanced fibrosis or cirrhosis has been focus of intense research&#46; Although liver biopsy is still the gold standard for NASH and liver fibrosis diagnosis&#44; the associated costs and potential adverse events precludes its use as a surveillance method to detect NAFLD in general population&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> A wide number of non-invasive biomarkers have been validated for assessing the severity of liver fibrosis in NAFLD&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> One of the most extensively validated scores is the NAFLD fibrosis score &#40;NFS&#41;&#44; which accurately predicts NAFLD patients with advanced fibrosis<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> and is recommended for non-invasive assessment in current AASLD and EASL guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> A metanalysis of thirteen studies &#40;n &#61; 3064&#41; estimated the AUROC&#44; sensitivity and specificity of NFS on predicting advanced fibrosis was 0&#46;85 &#40;0&#46;80-0&#46;93&#41;&#44; 0&#46;90 &#40;0&#46;82-0&#46;99&#41; and 0&#46;97 &#40;0&#46;94-0&#46;99&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> NFS has also been validated in Latin-American population&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="p0020" class="elsevierStylePara elsevierViewall">The diagnosis of advanced liver fibrosis and cirrhosis in T2DM patients has important implications&#44; since it enables high-risk patients to undergo esophageal varices and HCC surveillance&#46; However&#44; data on the prevalence of advanced liver disease in T2DM is still scarce&#46; Therefore&#44; the aim of this study was to assess the frequency of advanced liver disease among T2DM patients using non-invasive surveillance approach&#46; For this purpose we evaluated the prevalence of steatosis&#44; advanced fibrosis and cirrhosis in an otherwise unselected &#62; 55 years-old T2DM patients population using the NFS and magnetic resonance imaging &#40;MRI&#41;&#46;</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Material and Methods</span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Patient population</span><p id="p0025" class="elsevierStylePara elsevierViewall">We asked for diabetologists and family physicians to invite their diabetic patients older than 55 years old for liver disease surveillance assessment&#46; After referral&#44; patients were evaluated by our team and enrolled if they met the following inclusion criteria&#58;<ul class="elsevierStyleList" id="l0005"><li class="elsevierStyleListItem" id="u0005"><span class="elsevierStyleLabel">&#8226;</span><p id="p0030" class="elsevierStylePara elsevierViewall">Presence of type 2 diabetes mellitus&#46;</p></li><li class="elsevierStyleListItem" id="u0010"><span class="elsevierStyleLabel">&#8226;</span><p id="p0035" class="elsevierStylePara elsevierViewall">Being &#62; 55 years-old&#46;</p></li><li class="elsevierStyleListItem" id="u0015"><span class="elsevierStyleLabel">&#8226;</span><p id="p0040" class="elsevierStylePara elsevierViewall">No history of liver disease&#46;</p></li><li class="elsevierStyleListItem" id="u0020"><span class="elsevierStyleLabel">&#8226;</span><p id="p0045" class="elsevierStylePara elsevierViewall">Alcohol consumption &#60; 20 g&#47;day in women and &#60; 30 g&#47;day in men&#46;</p></li><li class="elsevierStyleListItem" id="u0025"><span class="elsevierStyleLabel">&#8226;</span><p id="p0050" class="elsevierStylePara elsevierViewall">No use of hepatotoxic drugs &#40;over 4 g&#47;day of acetaminophen&#44; methotrexate&#44; nitrofurantoin&#44; and rifampicin&#41;&#46;</p></li><li class="elsevierStyleListItem" id="u0030"><span class="elsevierStyleLabel">&#8226;</span><p id="p0055" class="elsevierStylePara elsevierViewall">Agree and sign the informed consent form in agreement with the ethical guidelines of the 1975 Declaration of Helsinki&#46;</p></li></ul></p><p id="p0060" class="elsevierStylePara elsevierViewall">The study was approved by the Pontificia Universidad Cat&#243;lica de Chile Human Research Committee&#46;</p></span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0030">Clinical examination and liver assessment</span><p id="p0065" class="elsevierStylePara elsevierViewall">For all patients&#44; clinical and biochemical parameters were determined at baseline&#46; Clinical parameters included height and weight measurements&#44; body mass index &#40;BMI&#41;&#44; blood pressure&#44; hypertension and dyslipidemia history&#44; alcohol use &#40;g&#47;day&#41;&#44; duration of diabetes&#44; relatives with diabetes&#44; microvascular complications &#40;retinopathy&#44; nephropathy and neuropathy&#41;&#44; and macrovascular complications &#40;myocardial infarction&#44; stroke or revascularization&#41;&#46; Alcohol consumption was estimated by an experienced interviewer &#40;Physician&#44; MSc Clinical nutrition&#41;&#44; who estimated it based on alcohol degrees &#40;percentage of alcohol per total volume&#41; and amount of alcohol consumed&#46; Subjects that consumed one drink per month or less were considered as no alcohol drinkers&#46;</p><p id="p0070" class="elsevierStylePara elsevierViewall">Biochemical parameters measured included the following&#58; liver chemistry &#40;including serum levels of aspartate aminotransferase &#91;AST&#93;&#44; alanine aminotransferase &#91;ALT&#93;&#44; alkaline phosphatase&#44; gammaglutamyl transpeptidase &#91;GGT&#93; and total bilirubin&#41;&#44; fasting glucose&#44; fasting serum insulin&#44; glycated hemoglobin A1c &#40;HbA1c&#41;&#44; lipid profile and complete blood count&#46; On insulin requiring patients&#44; fasting serum insulin was not measured&#46; Homeostasis model assessment of insulin resistance &#40;HOMA-IR&#41; index was calculated according to the standard formula&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="p0075" class="elsevierStylePara elsevierViewall">NFS was calculated as described in Angulo&#44; <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Anthropometry was assessment was also included &#40;height&#44; weight and waist circumference&#41;&#46; Metabolic syndrome was diagnosed based on ATP III criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> All patients had no markers of infection by hepatitis B or C viruses&#46;</p><p id="p0080" class="elsevierStylePara elsevierViewall">Magnetic resonance imaging were performed using a Philips Intera&#174; 1&#46;5T system &#40;Achieva&#44; Philips&#44; Best&#44; The Netherlands&#41;&#46; The MR protocol included the following sequences&#58; T2 with fat saturation&#44; T1 gradient echo&#44; half-Fourier single-shot turbo spin echo&#44; inphase and out-of phase sequences&#46; Liver steatosis was graduated in MRI using a gradient echo sequence employing the IDEAL method<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> and categorized as it follows&#58; 1&#58; mild&#44; 2&#58; moderate and 3&#58; severe&#46;</p><p id="p0085" class="elsevierStylePara elsevierViewall">The presence of liver cirrhosis in MRI was assessed using conventional morphological criteria such as enlarged caudate lobe and left lobe lateral segment &#40;segments II and III&#41; with concomitant atrophy of the posterior segments &#40;VI and VII&#41; of the right lobe&#44; enlargement of hiliar portal space&#44; nodular surface of the liver and increased spleen diameter&#46;<a class="elsevierStyleCrossRefs" href="#bib0095">19</a>-<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> Liver biopsy was offered to selected patients based on current recommendations&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p><p id="p0090" class="elsevierStylePara elsevierViewall">Based on the available data patients were classified in one of the following categories&#58;<ul class="elsevierStyleList" id="l0010"><li class="elsevierStyleListItem" id="u0035"><span class="elsevierStyleLabel">&#8226;</span><p id="p0095" class="elsevierStylePara elsevierViewall">No evidence of liver disease&#46;</p></li><li class="elsevierStyleListItem" id="u0040"><span class="elsevierStyleLabel">&#8226;</span><p id="p0100" class="elsevierStylePara elsevierViewall">As having steatosis if steatosis was present on imaging studies&#46;</p></li><li class="elsevierStyleListItem" id="u0045"><span class="elsevierStyleLabel">&#8226;</span><p id="p0105" class="elsevierStylePara elsevierViewall">As having advanced liver fibrosis if the NFS value was over 0&#44;675&#46;</p></li><li class="elsevierStyleListItem" id="u0050"><span class="elsevierStyleLabel">&#8226;</span><p id="p0110" class="elsevierStylePara elsevierViewall">As having cirrhosis based on the liver morphology on MRI&#46;</p></li></ul></p></span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0035">Data analysis</span><p id="p0115" class="elsevierStylePara elsevierViewall">Clinical and biochemical variables are presented as mean &#177; standard deviation &#40;SD&#41; for continuous data with normal distribution&#46; Median &#40;Q1&#8211;Q3&#41; for those variables without normal distribution and as percentage for categorical data&#46; Clinical data were analyzed employing &#967;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> test for categorical variables and Student <span class="elsevierStyleItalic">t</span>-test for continuous variables following a normal distribution&#46; Variables without normal distribution were analyzed by using MannWhitney <span class="elsevierStyleItalic">U</span> test&#46; Receiver-operating characteristic &#40;ROC&#41; curves were used to obtain a cut-off value when the area under the curve was larger than 60&#37;&#46; Based on ROC curve cut-off values&#44; continuous variables were transformed into discrete ones&#46; Univariate and multivariate analyses were performed&#46; Potential clinical and biochemical variables associated with advanced liver fibrosis were examined by comparing the means and proportions of variables among people with or without advanced liver fibrosis&#46; To study these relationships further&#44; univariate analysis was performed using &#967;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> test for categorical variables and Student <span class="elsevierStyleItalic">t</span>-test for continuous variables&#46; In order to identify independent variables associated with advanced liver fibrosis&#44; a stepwise procedure for a multivariate logistic regression analysis was conducted&#44; which included variables that appeared significant in univariate analysis&#46; Log transformation was performed for variables not normally distributed&#46; Variables involved in the estimation of NFS were excluded to avoid multicollinearity&#46; The &#967; trend test was performed to evaluate possible statistical tendencies for the additive value of variables found to be significant in multivariate analysis&#46; Analyses were performed using IBM SPSS Statistics 20 version software &#40;Chicago&#44; IL&#41;&#46; Odds ratio &#40;OR&#41; and 95&#37; confidence intervals &#40;CI&#41; were calculated&#46; Differences were considered significant when P-values &#60; 0&#46;05&#46;</p></span></span><span id="s0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0040">Results</span><span id="s0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0045">General features of patients</span><p id="p0120" class="elsevierStylePara elsevierViewall">A total of 145 patients were enrolled between March 2011 and April 2014&#46; One hundred thirty-six patients agreed to undergo an abdomen MRI and were evaluated for anthropometry&#44; clinical and laboratory measurements&#46; Three patients did not attend to MRI evaluation&#59; hence 133 patients underwent MRI assessment&#46; The general features of enrolled patients are shown in <a class="elsevierStyleCrossRef" href="#t0005">table 1</a>&#46; 52&#46;6&#37; were women&#44; the median age was 60 years old &#40;57-64&#41;&#44; the mean BMI was 29&#46;6 &#177; 4&#46;7 kg&#47;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#44; the mean diabetes duration since diagnosis was 7&#46;6 &#177; 6&#46;9 years and the median HbA1c levels was 6&#46;9&#37; &#40;6&#46;3&#8211;7&#46;9&#41; &#91;52 mmol&#47;mol &#40;45-63&#41;&#93;&#46; Of note&#44; 66&#46;7&#37; of patients met the criteria for metabolic syndrome&#44; 10&#46;5&#37; had history of macrovascular complications&#44; and the median HOMA-IR was 3&#46;9 &#40;2&#46;7&#8211;6&#46;2&#41;&#46;</p><elsevierMultimedia ident="t0005"></elsevierMultimedia></span><span id="s0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0050">Prevalence of liver disease</span><p id="p0125" class="elsevierStylePara elsevierViewall">Of the 133 patients studied 43 &#40;32&#46;3&#37;&#41; showed no evidence of liver disease&#46; Ninety-three patients had abnormal findings including 85 &#40;63&#46;9&#37;&#41; with radiological steatosis and 8 &#40;6&#46;0&#37;&#41; with evidence of cirrhosis in the abdominal MRI&#46; Seventeen patients &#40;12&#46;8&#37;&#41; of the group had a NFS &#62; 0&#46;675 suggesting the presence of advanced liver fibrosis&#46; Only one subject agreed to have liver biopsy because of persistently elevated liver tests&#46; She was classified as liver steatosis without cirrhosis on MRI analysis and advanced fibrosis by NFS on non-invasive assessment&#46; Liver biopsy demonstrated NASH with stage 3 fibrosis&#46;</p></span><span id="s0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0055">Variables associated to advanced liver fibrosis</span><p id="p0130" class="elsevierStylePara elsevierViewall">Variables associated to advanced liver fibrosis or cirrhosis in a univariate analysis are shown in <a class="elsevierStyleCrossRef" href="#t0010">table 2</a>&#46; Daily alcohol consumption&#44; serum levels of GGT&#44; platelet count and albumin were associated with the presence of advanced liver disease&#46; Notably&#44; when a cut off on GGT level was established we were able to improve its discriminative power &#40;AUC 0&#46;728&#44; 95&#37; CI 0&#46;604-0&#46;852&#44; p &#61; 0&#46;002&#44; sensibility 35&#37;&#44; specificity 93&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0010">Table 2</a>&#41;&#46; A multivariate analysis showed that a GGT &#62; 82 IU&#47;L and no alcohol consumption were independently related to advanced fibrosis&#44; as is shown in <a class="elsevierStyleCrossRef" href="#t0015">table 3</a>&#46;</p><elsevierMultimedia ident="t0010"></elsevierMultimedia><elsevierMultimedia ident="t0015"></elsevierMultimedia></span></span><span id="s0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0060">Discussion</span><p id="p0135" class="elsevierStylePara elsevierViewall">The issue of detecting liver disease in diabetics is relevant since cirrhosis is a significant cause of morbidity and mortality in this patient population<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and this end-organ damage is frequently overlooked in the primary care setting&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> In the present study we used a non-invasive surveillance approach for detecting liver disease in unselected diabetic patients older than 55 years-old&#46; Considering our inclusion criteria&#44; liver alterations found in our assessment are more likely to be related to NAFLD&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> The frequency of steatosis &#40;63&#46;9&#37;&#41; see in our T2DM patients is similar to figures found in two recent reports conducted in primary care setting that used magnetic resonance spectroscopy and MRI assessment respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> Previous data on NAFLD prevalence in diabetic patients is mostly ultrasound-based and included patients of different ages&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> In our study we selected T2DM patients with &#62; 55 years old&#44; and used an MRI based diagnosis of steatosis which is a more sensitive diagnostic test&#46; Hence&#44; the prevalence of NAFLD was within the higher end of previous reports and in agreement with the recent report by Doycheva&#44; <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> &#40;65&#37;&#41; that used MRI for steatosis assessment&#46; A more recent report that screened diabetic patients using a novel ultrasound-based technique &#40;controlled attenuation parameter&#41; to detect NAFLD found that 72&#46;8&#37; of subjects had evidence of steatosis&#44; which is also consistent with our findings&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> Noteworthy&#44; we found a significant proportion of diabetic patients with evidence of advanced liver disease including those with significant liver fibrosis &#40;12&#46;8&#37;&#41; and undiagnosed liver cirrhosis &#40;6&#46;0&#37;&#41;&#46; These figures are also in agreement with the recent report by Doycheva&#44; <span class="elsevierStyleItalic">et al</span>&#46; that enrolled 100 consecutive patients with T2DM &#40;mean age 59&#46;7 and BMI 30&#46;8 kg&#47;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> without liver disease&#41; and found that advanced liver fibrosis &#40;as assessed by MRI elastography&#41; in 7&#46;1&#37; of their patients<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> and with the report by Kwok&#44; <span class="elsevierStyleItalic">et al&#46;</span> that&#44; using liver stiffness measurements&#44; found that 17&#46;7&#37; of diabetics had significant liver fibrosis&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> When compared with the general population&#44; the frequency of advanced liver fibrosis &#40;significant fibrosis and cirrhosis&#41; in T2DM patients seems to be significantly higher although the information on prevalence of&#44; and variables associated with&#44; liver fibrosis in general population is scarce&#46; Some authors have roughly estimated the prevalence of liver cirrhosis in 1&#37; of the general population using transient elastography based diagnosis&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> but data is limited&#46; The recent study of Koehler&#44; <span class="elsevierStyleItalic">et al</span>&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> a population-based study among subjects &#62; 45 years&#44; found a 5&#46;6&#37; of the individuals with clinically relevant liver fibrosis assessed by liver stiffness measurement&#46; Interestingly&#44; in this study diabetes was strongly associated with liver fibrosis confirming that this subgroup of individuals is at risk of liver disease&#46; Collectively&#44; the available data including that of the present study&#44; give support to the concept that advanced liver disease&#44; likely secondary to progressive NAFLD&#44; is an important and under-recognized condition in T2DM patients and that awareness about this issue among health care providers of diabetic patients should be improved in order to increase the detection of patients at risk of developing or having liver fibrosis&#47;cirrhosis and prevent their complications&#46;</p><p id="p0140" class="elsevierStylePara elsevierViewall">In our study&#44; the multivariate analysis showed that serum levels of GGT and absence of alcohol consumption were independently associated with advanced fibrosis assessed by NFS&#46; The association between liver fibrosis and elevated GGT is in line with prior studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">31</span></a><span class="elsevierStyleSup">&#8211;</span><a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> Hence&#44; serum levels of GGT may have value in detecting significant fibrosis in diabetic subjects&#46; As for the potential protective role of moderate alcohol intake in NAFLD&#44; this has been previously reported in nondiabetic subjects&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">34</span></a><span class="elsevierStyleSup">&#8211;</span><a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a> The mechanisms that explain this protective effect of alcohol consumption on NAFLD are unknown&#59; however&#44; it can be related to the anti-oxidant effects of some alcoholic beverages&#44; such as red wine&#44; that can reduce reactive oxygen species and reduce cell damage in the setting of NASH&#46; Patients who consume alcohol have increased circulating adiponectin&#44; which has a protective role in NAFLD mediated through adenosine monophosphate-activated protein kinase and peroxisome proliferator-activated receptor a enhanced by activation of adiponectin receptor 2 in hepatocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a> Importantly&#44; we do not recommend to promote drinking habits in NAFLD patients &#40;evidence 1B&#44; AASLD guidelines&#41;&#44; however there is no evidence to completely stop alcohol in NAFLD patients with non-significant drinking habits as our data support a potential protective effect&#46;</p><p id="p0145" class="elsevierStylePara elsevierViewall">As in previous reports&#44; the main limitation of the present study is the absence of liver histology assessment&#46; Since many patients and physicians are reluctant to perform or undergo liver biopsy due to associated health costs and potential adverse events&#44; this study was designed to use a non-invasive approach to determine the prevalence of liver disease and cirrhosis in unselected diabetic patients older than 55 years-old taken into account the fact that liver fibrosis increases with age in NAFLD&#44; which has been recently shown also in diabetics&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> Regarding liver fibrosis&#44; we used the most extensively validated score &#40;NFS&#41;&#44; recommended in most of current guidelines NAFLD for non-invasive liver fibrosis assessment&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> However data on validation of these scores in diabetic population is scarce and there is no consensus in cut-off values&#46; In addition&#44; 75 subjects presented indeterminate NFS&#44; many of them might present advanced fibrosis if they undergo histology assessment&#46; Based on these facts&#44; we believe our surveillance approach is likely to underestimate the prevalence of advanced liver fibrosis&#46; Regarding liver cirrhosis diagnosis&#44; we selected the morphological features that have been described to have a high sensitivity &#40;87-93&#37;&#41; and specificity &#40;92&#37;&#41; for cirrhosis diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> Another limitation of our study is the possibility of selection bias on the referral&#59; however patients were consecutively invited directly on diabetes and family medicine clinics and referred to our team&#46; In spite of the limitations of our non-invasive diagnosis&#44; we observed that our estimate of advanced liver disease &#40;12&#46;8&#37; of significant fibrosis plus 6&#37; cirrhosis&#41; is in agreement with findings using other techniques such as MRI elastography<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> and vibration controlled transient elastography&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a></p><p id="p0150" class="elsevierStylePara elsevierViewall">Current diabetes society guidelines<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> do not provide specific recommendations for liver assessment in diabetic patients&#46; We believe that our data and that of other recent studies<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> strongly suggest that patients with T2DM may benefit from screening of liver fibrosis&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> The early diagnosis of significant fibrosis would give the opportunity for lifestyle and pharmacologic intervention to prevent further progression of liver disease which would be meaningful in the context of emerging therapies for NAFLD&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a> However&#44; even more important is the early diagnosis of liver cirrhosis&#44; since patients with this condition would benefit of esophageal varices and HCC surveillance&#46; Timely diagnosis will enable the implementation of primary prophylaxis for variceal bleeding and&#47;or curative treatment for early HCC if detected&#46; The best strategy to screen T2DM for liver fibrosis remains to be established but current non-invasive tests for evaluation of liver disease severity and prognosis guidelines suggest that NFS and transient elastography are good options&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Further research is needed to confirm the cost-effectiveness of this approach and to better define both the natural history of NAFLD in T2DM and the effect of novel treatments on it&#46;</p></span><span id="s0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0065">Conclusion</span><p id="p0155" class="elsevierStylePara elsevierViewall">The present study shows that T2DM patients have significant rates of NAFLD&#44; advanced liver fibrosis and cirrhosis&#46; Screening of these conditions using non-invasive tests may be warranted after validation in larger prospective studies&#46;</p></span><span id="s0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0070">Abbreviations</span><p id="p0160" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="l0015"><li class="elsevierStyleListItem" id="u0055"><span class="elsevierStyleLabel">&#8226;</span><p id="p0165" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">ALT&#58;</span> alanine aminotransferase&#46;</p></li><li class="elsevierStyleListItem" id="u0060"><span class="elsevierStyleLabel">&#8226;</span><p id="p0170" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">AST&#58;</span> aspartate aminotransferase&#46;</p></li><li class="elsevierStyleListItem" id="u0065"><span class="elsevierStyleLabel">&#8226;</span><p id="p0175" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">BMI&#58;</span> body mass index&#46;</p></li><li class="elsevierStyleListItem" id="u0070"><span class="elsevierStyleLabel">&#8226;</span><p id="p0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">GGT&#58;</span> gamma-glutamyl transpeptidase&#46;</p></li><li class="elsevierStyleListItem" id="u0075"><span class="elsevierStyleLabel">&#8226;</span><p id="p0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">HCC&#58;</span> hepatocellular carcinoma&#46;</p></li><li class="elsevierStyleListItem" id="u0080"><span class="elsevierStyleLabel">&#8226;</span><p id="p0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">MRI&#58;</span> magnetic resonance imaging&#46;</p></li><li class="elsevierStyleListItem" id="u0085"><span class="elsevierStyleLabel">&#8226;</span><p id="p0195" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">NAFLD&#58;</span> Non-Alcoholic Fatty Liver Disease&#46;</p></li><li class="elsevierStyleListItem" id="u0090"><span class="elsevierStyleLabel">&#8226;</span><p id="p0200" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">NASH&#58;</span> Non-Alcoholic Steatohepatitis&#46;</p></li><li class="elsevierStyleListItem" id="u0095"><span class="elsevierStyleLabel">&#8226;</span><p id="p0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">NFS&#58;</span> NAFLD fibrosis score&#46;</p></li><li class="elsevierStyleListItem" id="u0100"><span class="elsevierStyleLabel">&#8226;</span><p id="p0210" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">ROC&#58;</span> receiver-operating characteristic&#46;</p></li><li class="elsevierStyleListItem" id="u0105"><span class="elsevierStyleLabel">&#8226;</span><p id="p0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">T2DM&#58;</span> type 2 diabetes mellitus&#46;</p></li></ul></p></span><span id="s0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0075">Support</span><p id="p0220" class="elsevierStylePara elsevierViewall">This study was carried out with support of grants from the Fondo Nacional de Investigaci&#243;n Cient&#237;fica y Tecnol&#243;gica &#40;FONDECYT 1150327 to M&#46;A&#46; and 1150311 to F&#46;B&#46;&#41; and the Comisi&#243;n Nacional de Investigaci&#243;n Cient&#237;fica y Tecnol&#243;gica &#40;grant PIA&#47;Basal PFB12&#47;2007&#44; Basal Centre for Excellence in Science and Technology and ACT79 &#91;to M&#46;A&#46;&#93;&#41; from the Government of Chile&#46; The funding source did not have any role in study design or in data collection&#44; analysis and interpretation&#46;</p></span><span id="s0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0080">Conflict of Interests</span><p id="p0225" class="elsevierStylePara elsevierViewall">Authors have no relevant conflict of interest to disclose&#46;</p></span></span>"
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          "titulo" => "Abstract"
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              "identificador" => "abs0010"
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          "identificador" => "xpalclavsec1116635"
          "titulo" => "Keywords"
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        2 => array:2 [
          "identificador" => "s0005"
          "titulo" => "Introduction"
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        3 => array:3 [
          "identificador" => "s0010"
          "titulo" => "Material and Methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "s0015"
              "titulo" => "Patient population"
            ]
            1 => array:2 [
              "identificador" => "s0020"
              "titulo" => "Clinical examination and liver assessment"
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            2 => array:2 [
              "identificador" => "s0025"
              "titulo" => "Data analysis"
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        ]
        4 => array:3 [
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          "titulo" => "Results"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "s0035"
              "titulo" => "General features of patients"
            ]
            1 => array:2 [
              "identificador" => "s0040"
              "titulo" => "Prevalence of liver disease"
            ]
            2 => array:2 [
              "identificador" => "s0045"
              "titulo" => "Variables associated to advanced liver fibrosis"
            ]
          ]
        ]
        5 => array:2 [
          "identificador" => "s0050"
          "titulo" => "Discussion"
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        6 => array:2 [
          "identificador" => "s0055"
          "titulo" => "Conclusion"
        ]
        7 => array:2 [
          "identificador" => "s0060"
          "titulo" => "Abbreviations"
        ]
        8 => array:2 [
          "identificador" => "s0065"
          "titulo" => "Support"
        ]
        9 => array:2 [
          "identificador" => "s0070"
          "titulo" => "Conflict of Interests"
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        10 => array:1 [
          "titulo" => "References"
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    "fechaRecibido" => "2015-11-30"
    "fechaAceptado" => "2016-02-09"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1116635"
          "palabras" => array:8 [
            0 => "NAFLD"
            1 => "NASH"
            2 => "Fibrosis"
            3 => "Diabetes"
            4 => "Insulin resistance"
            5 => "Obesity"
            6 => "Metabolic Syndrome"
            7 => "Mortality"
          ]
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    "resumen" => array:1 [
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        "titulo" => "Abstract"
        "resumen" => "<span id="abs0010" class="elsevierStyleSection elsevierViewall"><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Background&#46;</span> Patients with type 2 diabetes mellitus &#40;T2DM&#41; are at risk for developing end-stage liver disease due to nonalcoholic steatohepatitis &#40;NASH&#41;&#44; the aggressive form of non-alcoholic fatty liver disease &#40;NAFLD&#41;&#46; Data on prevalence of advanced fibrosis among T2DM patients is scarce&#46; Aim&#46; To evaluate prevalence of steatosis&#44; advanced fibrosis and cirrhosis using non-invasive methods in T2DM patients&#46;</p><p id="sp7040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Material and methods&#46;</span> 145 consecutive T2DM patients &#40;&#62; 55 years-old&#41; were prospectively recruited&#46; Presence of cirrhosis and advanced fibrosis was evaluated by magnetic resonance imaging &#40;MRI&#41; and NAFLD fibrosis score &#40;NFS&#41; respectively&#46; Exclusion criteria included significant alcohol consumption&#44; markers of viral hepatitis infection or other liver diseases&#46; Results are expressed in percentage or median &#40;interquartile range&#41;&#46;</p><p id="sp2040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Results&#46;</span> 52&#46;6&#37; of patients were women&#44; the median age was 60 years old &#40;57-64&#41;&#44; mean BMI was 29&#46;6 &#177; 4&#46;7 kg&#47;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and diabetes duration was 7&#46;6 &#177; 6&#46;9 years&#46; A high prevalence of liver steatosis &#40;63&#46;9&#37;&#41;&#44; advanced fibrosis assessed by NFS &#40;12&#46;8&#37;&#41; and evidence of liver cirrhosis in MRI &#40;6&#46;0&#37;&#41; was observed&#46; In a multivariate analysis GGT &#62; 82 IU&#47;L &#40;P &#61; 0&#46;004&#41; and no alcohol intake &#40;P &#61; 0&#46;032&#41; were independently associated to advanced fibrosis&#46;</p><p id="sp3040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusion&#46;</span> A high frequency of undiagnosed advanced fibrosis and cirrhosis was observed in non-selected T2DM patients&#46; Screening of these conditions may be warranted in this patient population&#46;</p></span>"
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          "leyenda" => "<p id="np0005" class="elsevierStyleSimplePara elsevierViewall">AST&#58; aspartate aminotransferase&#46; ALT&#58; alanine aminotransferase&#46; GGT&#58; gamma-glutamyl transferase&#46; LDL&#58; low-density lipoprotein&#46; HDL&#58; high-density lipoprotein&#46; HOMA-IR&#58; Homeostasis Model Assessment of Insulin Resistance&#46; Results are expressed in median &#40;interquartile range&#41; for variables with abnormal distribution and average &#177; standard deviation for variables with normal distribution&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#61; 133&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Age&#44; years&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#40;57- 64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 &#40;47&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dyslipidemia&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;50&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Waist circumference &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&#46;2 &#177; 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#46;5 &#177; 11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Metabolic syndrome&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89 &#40;66&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Number first relative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">with diabetes&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;27&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;42&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;29&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Years of diabetes diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;6 &#177; 6&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Daily alcohol&#44; g&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;0- 14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0- 2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retinopathy history&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;13&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nephropathy history&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;6&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neuropathy history&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;12&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Macrovascular complications&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AST &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;17- 27&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ALT &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;19- 39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">GGT &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;19- 47&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total bilirubin &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;52 &#40;0&#46;43- 0&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alkaline Phosphatase &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;69- 103&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A lbumin &#40;g&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;5 &#40;4&#46;3- 4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDL cholesterol &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;8 &#40;67- 110&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HDL cholesterol &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;5 &#40;40- 54&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Triglycerides &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">141 &#40;105- 204&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Glycated hemoglobin A1c&#44;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;9 &#40;6&#46;3- 7&#46;9&#41; &#91;52 &#40;45-63&#41;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#37; &#91;mmol&#47;mol&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Platelet count&#44; &#215; 10<span class="elsevierStyleSup">9</span>&#47;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">227 &#40;187- 267&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hematocrit &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;3 &#177; 3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">White blood cell count &#40;&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;857 &#177; 1&#44;421&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinine &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;8 &#40;0&#46;68- 0&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urine albumin&#47;creatinine ratio &#40;pg&#47;mg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;3 &#40;3&#46;8- 17&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HOMA-IR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;9 &#40;2&#46;7- 6&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Body mass index &#40;BMI&#41;&#44; &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;6 &#177; 4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NAFLD fibrosis score &#40;NFS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 0&#46;675&#40;F3-4&#41;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;12&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2045909.png"
              ]
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">General features of enrolled patients&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "t0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:3 [
          "leyenda" => "<p id="np0010" class="elsevierStyleSimplePara elsevierViewall">GGT&#58; gamma-glutamyl transferase&#46; LDL&#58; low-density lipoprotein&#46; HDL&#58; high-density lipoprotein&#46; HOMA-IR&#58; Homeostasis Model Assessment of Insulin Resistance&#46; p-value obtained by&#58;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Advanced fibrosis &#40;n &#61; 17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Absence of advanced fibrosis &#40;n &#61; 116&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;58 - 68&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#40;57- 64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;103<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;35&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;49&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;286<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypertension&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;76&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;57&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;141<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dyslipidemia&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;47&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;50&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;770<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Waist circumference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103&#46;6 &#177; 8&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#46;1 &#177; 10&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;076<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Metabolic syndrome&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;70&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;66&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;835<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Number first relative with diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1- 3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0 - 2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;267<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Years of diabetes diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;4- 16&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;2 - 10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Daily alcohol &#40;g&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0- 0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;5 &#40;0 - 10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;011</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No alcohol consumption&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;82&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;49&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;01</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retinopathy history&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;358<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nephropathy history&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;6&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;973<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neuropathy history&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;17&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;12&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;455<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Macrovascular complications&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;11&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;793<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">GGT &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;31- 135&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;18 - 45&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;003</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">GGT &#62; 82 IU&#47;L&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;35&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;6&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;0004</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total bilirubin &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;53 &#40;0&#46;43 - 0&#46;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;51 &#40;0&#46;43 - 0&#46;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;584<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alkaline phosphatase &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91 &#40;76&#46;5 - 107&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;5 &#40;68&#46;3 - 101&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;262<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDL cholesterol &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96 &#40;79&#46;5 - 108&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;66 - 113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;622<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HDL cholesterol &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;42&#46;5 - 56&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;39 - 54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;471<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Triglycerides &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">144 &#40;136&#46;5 - 207&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">136 &#40;103 - 205&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;407<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Glycated hemoglobin A1c &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;3 &#40;6&#46;1 - 7&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;6&#46;3- 8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;072<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hematocrit &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;2 &#177; 4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;5 &#177; 3&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;754<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">White blood cell count &#40;&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;611 &#177; 1&#44;287&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;829 &#177; 1&#44;374&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;538<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Platelet count&#44; &#215; 10<span class="elsevierStyleSup">9</span>&#47;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">192 &#40;143&#46;5 - 211&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">234&#46;5 &#40;191&#46;3 - 269&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;001</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Albumin &#40;g&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;4 &#40;4&#46;2 - 4&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;5 &#40;4&#46;4 - 4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;001</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinine &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;72 &#40;0&#46;62 - 0&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;81 &#40;0&#46;68 - 0&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;142<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urine albumin&#47;creatinine ratio &#40;pg&#47;mg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;8 &#40;4&#46;2 - 21&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;9 &#40;3&#46;7 - 17&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;458<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                    0 => array:2 [
                      "titulo" => "Cost-of-illness studies of diabetes mellitus&#58; a systematic review"
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                          "etal" => false
                          "autores" => array:4 [
                            0 => "Ng C&#46;S&#46;"
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                            2 => "Toh M&#46;P&#46;"
                            3 => "Ko Y&#46;"
                          ]
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                      "doi" => "10.1016/j.diabres.2014.03.020"
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                        "tituloSerie" => "Diabetes Res Clin Pract"
                        "fecha" => "2014"
                        "volumen" => "105"
                        "paginaInicial" => "151"
                        "paginaFinal" => "163"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24814877"
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                      "titulo" => "Fatty liver disease in diabetes mellitus"
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                            0 => "Bhatt H&#46;B&#46;"
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                        "tituloSerie" => "Hepatobiliary Surg Nutr"
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                        "volumen" => "4"
                        "paginaInicial" => "101"
                        "paginaFinal" => "108"
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                          "autores" => array:4 [
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                        "paginaInicial" => "E526"
                        "paginaFinal" => "E531"
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                          0 => array:2 [
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                        "tituloSerie" => "J Clin Endocrinol Metab"
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                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The NAFLD fibrosis score&#58; a noninvasive system that identifies liver fibrosis in patients with NAFLD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Angulo P&#46;"
                            1 => "Hui J&#46;M&#46;"
                            2 => "Marchesini G&#46;"
                            3 => "Bugianesi E&#46;"
                            4 => "George J&#46;"
                            5 => "Farrell G&#46;C&#46;"
                            6 => "Enders F&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.21496"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2007"
                        "volumen" => "45"
                        "paginaInicial" => "846"
                        "paginaFinal" => "854"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17393509"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Liver fibrosis&#44; but no other histologic features&#44; is associated with long-term outcomes of patients with nonalcoholic fatty liver disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Angulo P&#46;"
                            1 => "Kleiner D&#46;E&#46;"
                            2 => "Dam-Larsen S&#46;"
                            3 => "Adams L&#46;A&#46;"
                            4 => "Bjornsson E&#46;S&#46;"
                            5 => "Charatcharoenwitthaya P&#46;"
                            6 => "Mills P&#46;R&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.gastro.2015.04.043"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterology"
                        "fecha" => "2015"
                        "volumen" => "149"
                        "paginaInicial" => "389"
                        "paginaFinal" => "397"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25935633"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The diagnosis and management of non-alcoholic fatty liver disease&#58; practice Guideline by the American Association for the Study of Liver Diseases&#44; American College of Gastroenterology&#44; and the American Gastroenterological Association"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Chalasani N&#46;"
                            1 => "Younossi Z&#46;"
                            2 => "Lavine J&#46;E&#46;"
                            3 => "Diehl A&#46;M&#46;"
                            4 => "Brunt E&#46;M&#46;"
                            5 => "Cusi K&#46;"
                            6 => "Charlton M&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.25762"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2012"
                        "volumen" => "55"
                        "paginaInicial" => "2005"
                        "paginaFinal" => "2023"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22488764"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-analysis&#58; natural history of non-alcoholic fatty liver disease &#40;NAFLD&#41; and diagnostic accuracy of non-invasive tests for liver disease severity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Musso G&#46;"
                            1 => "Gambino R&#46;"
                            2 => "Cassader M&#46;"
                            3 => "Pagano G&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/07853890.2010.518623"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Med"
                        "fecha" => "2011"
                        "volumen" => "43"
                        "paginaInicial" => "617"
                        "paginaFinal" => "649"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21039302"
                            "web" => "Medline"
                          ]
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                          "pii" => "S0022534716305833"
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                          "issn" => "00225347"
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                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation study of systems for noninvasive diagnosis of fibrosis in nonalcoholic fatty liver disease in Latin population"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "P&#233;rez-Guti&#233;rrez O&#46;Z&#46;"
                            1 => "Hern&#225;ndez-Rocha C&#46;"
                            2 => "Candia-Balboa R&#46;A&#46;"
                            3 => "Arrese M&#46;A&#46;"
                            4 => "Ben&#237;tez C&#46;"
                            5 => "Brizuela-Alc&#225;ntara D&#46;C&#46;"
                            6 => "M&#233;ndez-S&#225;nchez N&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Hepatol"
                        "fecha" => "2013"
                        "volumen" => "12"
                        "paginaInicial" => "416"
                        "paginaFinal" => "424"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23619258"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Definition of metabolic syndrome&#58; Report of the National Heart&#44; Lung&#44; and Blood Institute&#47;American Heart Association conference on scientific issues related to definition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Grundy S&#46;M&#46;"
                            1 => "Brewer H&#46;B&#46; Jr"
                            2 => "Cleeman J&#46;I&#46;"
                            3 => "Smith S&#46;C&#46; Jr"
                            4 => "Lenfant C&#46;"
                            5 => "American Heart A&#46;"
                            6 => "National Heart L&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.0000111245.75752.C6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2004"
                        "volumen" => "109"
                        "paginaInicial" => "433"
                        "paginaFinal" => "438"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14744958"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Water-fat separation with IDEAL gradient-echo imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Reeder S&#46;B&#46;"
                            1 => "McKenzie C&#46;A&#46;"
                            2 => "Pineda A&#46;R&#46;"
                            3 => "Yu H&#46;"
                            4 => "Shimakawa A&#46;"
                            5 => "Brau A&#46;C&#46;"
                            6 => "Hargreaves B&#46;A&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jmri.20831"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Magn Reson Imaging"
                        "fecha" => "2007"
                        "volumen" => "25"
                        "paginaInicial" => "644"
                        "paginaFinal" => "652"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17326087"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prediction of liver cirrhosis&#44; using diagnostic imaging tools"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Yeom S&#46;K&#46;"
                            1 => "Lee C&#46;H&#46;"
                            2 => "Cha S&#46;H&#46;"
                            3 => "Park C&#46;M&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4254/wjh.v7.i17.2069"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Hepatol"
                        "fecha" => "2015"
                        "volumen" => "7"
                        "paginaInicial" => "2069"
                        "paginaFinal" => "2079"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26301049"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enlargement of hilar periportal space&#58; a sign of early cirrhosis at MR imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Ito K&#46;"
                            1 => "Mitchell D&#46;G&#46;"
                            2 => "Gabata T&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Magn Reson Imaging"
                        "fecha" => "2000"
                        "volumen" => "11"
                        "paginaInicial" => "136"
                        "paginaFinal" => "140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10713945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Non-invasive diagnosis of liver cirrhosis&#58; magnetic resonance imaging presents special features"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Numminen K&#46;"
                            1 => "Tervahartiala P&#46;"
                            2 => "Halavaara J&#46;"
                            3 => "Isoniemi H&#46;"
                            4 => "Hockerstedt K&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Scand J Gastroenterol"
                        "fecha" => "2005"
                        "volumen" => "40"
                        "paginaInicial" => "76"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15841718"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for diagnosis&#44; referral for liver biopsy&#44; and treatment of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Spengler E&#46;K&#46;"
                            1 => "Loomba R&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mayocp.2015.06.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mayo Clin Proc"
                        "fecha" => "2015"
                        "volumen" => "90"
                        "paginaInicial" => "1233"
                        "paginaFinal" => "1246"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26219858"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for liver biopsy evaluation in non-alcoholic fatty liver disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Stinton L&#46;M&#46;"
                            1 => "Loomba R&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Minerva Gastroenterol Dietol"
                        "fecha" => "2014"
                        "volumen" => "60"
                        "paginaInicial" => "5"
                        "paginaFinal" => "13"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24632764"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Liver disease&#58; A neglected complication of diabetes mellitus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Arrese M&#46;"
                            1 => "Arab J&#46;P&#46;"
                            2 => "Arancibia J&#46;P&#46;"
                            3 => "Candia R&#46;"
                            4 => "Riquelme A&#46;"
                            5 => "Barrera F&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "editores" => "BagchiD&#46;, SreejayanN&#46;"
                        "titulo" => "Nutritional and therapeutic interventions for diabetes and metabolic syndrome"
                        "paginaInicial" => "289"
                        "paginaFinal" => "294"
                        "serieFecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis of non-alcoholic fatty liver disease &#40;NAFLD&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Yri-J&#228;rvinen H&#46;"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00125-016-3944-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetologia"
                        "fecha" => "2016"
                        "volumen" => "59"
                        "paginaInicial" => "1104"
                        "paginaFinal" => "1111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27091184"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Non-invasive screening of diabetics in primary care for NAFLD and advanced fibrosis by MRI and MRE"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Doycheva I&#46;"
                            1 => "Cui J&#46;"
                            2 => "Nguyen P&#46;"
                            3 => "Costa E&#46;A&#46;"
                            4 => "Hooker J&#46;"
                            5 => "Hofflich H&#46;"
                            6 => "Bettencourt R&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/apt.13405"
                      "Revista" => array:6 [
                        "tituloSerie" => "Aliment Pharmacol Ther"
                        "fecha" => "2016"
                        "volumen" => "43"
                        "paginaInicial" => "83"
                        "paginaFinal" => "95"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26369383"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonalcoholic fatty liver disease&#58; liver disease&#58; an overlooked complication of diabetes mellitus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Arrese M&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/nrendo.2010.173"
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                        "tituloSerie" => "Nat Rev Endocrinol"
                        "fecha" => "2010"
                        "volumen" => "6"
                        "paginaInicial" => "660"
                        "paginaFinal" => "661"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21102646"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283812006161"
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                          "issn" => "03022838"
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                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
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                0 => array:1 [
                  "referenciaCompleta" => "Kwok R&#44; Choi KC&#44; Wong GL&#44; Zhang Y&#44; Chan HL&#44; Luk AO&#44; Shu SS&#44; et al&#46; Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements&#58; a prospective cohort study&#46; <span class="elsevierStyleItalic">Gut</span> 2015&#46;"
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening the general population for cirrhosis using transient elastography&#58; finding a needle in a haystack&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Castera L&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/gut.2010.234203"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gut"
                        "fecha" => "2011"
                        "volumen" => "60"
                        "paginaInicial" => "883"
                        "paginaFinal" => "884"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21471569"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30&#46;"
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                0 => array:1 [
                  "referenciaCompleta" => "Koehler EM&#44; Plompen EP&#44; Schouten JN&#44; Hansen BE&#44; Darwish Murad S&#44; Taimr P&#44; Leebeek FW&#44; et al&#46; Presence of diabetes mellitus and steatosis is associated with liver stiffness in a general population&#58; The Rotterdam study&#46; <span class="elsevierStyleItalic">Hepatology</span> 2015&#46;"
                ]
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                      "titulo" => "Histopathological stages of nonalcoholic fatty liver disease in type 2 diabetes&#58; prevalences and correlated factors"
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                        "tituloSerie" => "Liver Int"
                        "fecha" => "2011"
                        "volumen" => "31"
                        "paginaInicial" => "700"
                        "paginaFinal" => "706"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21457442"
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                    0 => array:2 [
                      "titulo" => "Serum gamma-glutamyltranspeptidase distinguishes non-alcoholic fatty liver disease at high risk"
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                          "etal" => true
                          "autores" => array:7 [
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                            5 => "Can G&#46;"
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                        "paginaFinal" => "1438"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18795706"
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                          ]
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                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0165"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical predictors of different grades of nonalcoholic fatty liver disease"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Junior W&#46;S&#46;"
                            1 => "Nonino-Borges C&#46;B&#46;"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11695-011-0438-6"
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                        "tituloSerie" => "Obes Surg"
                        "fecha" => "2012"
                        "volumen" => "22"
                        "paginaInicial" => "248"
                        "paginaFinal" => "252"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21598007"
                            "web" => "Medline"
                          ]
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                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
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                0 => array:1 [
                  "referenciaCompleta" => "Hashimoto Y&#44; Hamaguchi M&#44; Kojima T&#44; Ohshima Y&#44; Ohbora A&#44; Kato T&#44; Nakamura N&#44; et al&#46; The modest alcohol consumption reduces the incidence of fatty liver in men&#59; a population based large scale cohort study&#46; <span class="elsevierStyleItalic">J Gastroenterol Hepatol</span> 2014&#46;"
                ]
              ]
            ]
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                    0 => array:2 [
                      "titulo" => "Alcohol consumption appears to protect against non-alcoholic fatty liver disease"
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                          "etal" => true
                          "autores" => array:7 [
                            0 => "Moriya A&#46;"
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                            2 => "Ohguchi S&#46;"
                            3 => "Kayashima E&#46;"
                            4 => "Mitsumune T&#46;"
                            5 => "Taniguchi H&#46;"
                            6 => "Ikeda F&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2036.2010.04520.x"
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                        "tituloSerie" => "Aliment Pharmacol Ther"
                        "fecha" => "2011"
                        "volumen" => "33"
                        "paginaInicial" => "378"
                        "paginaFinal" => "388"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21118396"
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                          ]
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                    ]
                  ]
                ]
              ]
            ]
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                      "titulo" => "Modest alcohol consumption is associated with decreased prevalence of steatohepatitis in patients with non-alcoholic fatty liver disease &#40;NAFLD&#41;"
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                        0 => array:2 [
                          "etal" => false
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                            1 => "Sanyal A&#46;J&#46;"
                            2 => "Brunt E&#46;M&#46;"
                            3 => "Unalp-Arida A&#46;"
                            4 => "Donohue M&#46;"
                            5 => "McCullough A&#46;J&#46;"
                            6 => "Schwimmer J&#46;B&#46;"
                          ]
                        ]
                      ]
                    ]
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                        "tituloSerie" => "J Hepatol"
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                      "titulo" => "Modest wine drinking and decreased prevalence of suspected nonalcoholic fatty liver disease"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "Dunn W&#46;"
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                    0 => array:2 [
                      "doi" => "10.1002/hep.22292"
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                        "tituloSerie" => "Hepatology"
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                        "volumen" => "47"
                        "paginaInicial" => "1947"
                        "paginaFinal" => "1954"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18454505"
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                      "titulo" => "Role of adiponectin in the protective action of dietary saturated fat against alcoholic fatty liver in mice"
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                          "etal" => false
                          "autores" => array:5 [
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16108051"
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                      "titulo" => "Management of nonalcoholic fatty liver disease&#58; an evidence-based clinical practice review"
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                        "tituloSerie" => "World J Gastroenterol"
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                        "paginaFinal" => "12201"
                        "link" => array:1 [
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                      "titulo" => "Pharmacotherapy for Nonalcoholic Fatty Liver Disease"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Gawrieh S&#46;"
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                        "tituloSerie" => "Semin Liver Dis"
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                        "volumen" => "35"
                        "paginaInicial" => "338"
                        "paginaFinal" => "348"
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Article information

ISSN: 16652681
Original language: English

DOI:10.5604/16652681.1212434

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Year/Month	Html	Pdf	Total

2024 November	4	0	4
2024 October	14	1	15
2024 September	18	5	23
2024 August	14	3	17
2024 July	16	4	20
2024 June	12	2	14
2024 May	12	1	13
2024 April	20	5	25
2024 March	15	5	20
2024 February	14	13	27
2024 January	4	14	18
2023 December	6	24	30
2023 November	10	15	25
2023 October	11	3	14
2023 September	13	5	18
2023 August	16	4	20
2023 July	15	2	17
2023 June	32	7	39
2023 May	41	4	45
2023 April	61	5	66
2023 March	36	2	38
2023 February	39	6	45
2023 January	25	7	32
2022 December	19	5	24
2022 November	20	3	23
2022 October	28	7	35
2022 September	24	6	30
2022 August	26	4	30
2022 July	23	6	29
2022 June	23	6	29
2022 May	18	4	22
2022 April	31	9	40
2022 March	27	8	35
2022 February	23	5	28
2022 January	41	8	49
2021 December	17	12	29
2021 November	24	9	33
2021 October	25	21	46
2021 September	18	13	31
2021 August	26	7	33
2021 July	18	9	27
2021 June	21	8	29
2021 May	22	9	31
2021 April	68	9	77
2021 March	47	5	52
2021 February	25	7	32
2021 January	21	11	32
2020 December	30	18	48
2020 November	28	18	46
2020 October	20	6	26
2020 September	16	7	23
2020 August	21	12	33
2020 July	15	7	22
2020 June	17	6	23
2020 May	20	19	39
2020 April	12	4	16
2020 March	22	9	31
2020 February	19	7	26
2020 January	6	6	12
2019 December	7	8	15
2019 November	7	1	8
2019 October	10	2	12
2019 September	2	1	3
2019 August	1	1	2
2019 July	1	7	8
2019 June	6	9	15
2019 May	2	4	6

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