Prevalence of high-risk non-alcoholic steatohepatitis according to the fast® index in a group of diabetic patients

ISSN: 1665-2681

Annals of Hepatology (AoH) is an international, open access journal published bi-monthly with funds from the Fundación Clínica Médica Sur. It is the official journal of the Mexican Association of Hepatology (AMH), the Latin American Association for the Study of the Liver (ALEH), the Canadian Association for the Study of the Liver (CASL) and the Czech Society of Hepatology (CSH). AoH publishes editorials, opinions, concise reviews, original articles, brief reports, letters to the editor, news from affiliated associations, clinical practice guidelines and summaries of congresses in the field of Hepatology.

Topics covered by AoH include alcoholic liver disease, autoimmune hepatitis, biliary diseases, drug-induced liver injury, genetic liver diseases, NAFLD/NASH and viral hepatitis (HAV, HBV, HCV, HDV, HEV). Our journal seeks to publish articles on basic clinical care and translational research focused on preventing rather than treating the complications of end-stage liver disease.

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Diabetes is a high-risk condition for the progression of metabolic fatty liver disease (MAFLD). The FAST index combines the result of transition elastography (Fibroscan®) and AST levels and is used to predict the risk of suffering from non-alcoholic steatohepatitis (NASH) with a high risk of progression (NAS >4, F>2). This study aimed to know what proportion of diabetic patients is at risk of suffering from high-risk NASH according to the FAST® index.

Materials and Methods

Observational, transversal study to estimate prevalence. Diabetic patients who agreed to perform Fibroscan® and liver biochemical profile were included, and the FAST® index was calculated (<0.35 without risk; ≤ 0.35 to <0.67 indeterminate; ≥ 0.67 high-risk NASH). Descriptive statistics were used.

Results

One hundred fifty diabetic patients were included; 106 (70.7%) women; mean age 56.5±10.5 years. According to the steatosis degree by controlled attenuation parameter (CAP): S0=71(47.3%), S1=14(9.3%), S2=29(19.3%), S3=36(24%). According to the fibrosis degree (KPa): F0=82(54.7%), F1=4(2.7%), F2=8(5.3%), F3=9(6.0%), F4=47(31.3%). According to the FAST index: without risk= 96 (64%), indeterminate= 24 (16.0%), and with high risk= 30 (20%). There was no correlation between the HbA1c levels, diabetes evolution, obesity degree, or the presence of dyslipidemia.

Conclusions

The NASH high-risk progression's prevalence is high in diabetic patients; The factors that determine this risk in this population are still not clear, but timely detection strategies are required to efficiently identify this subgroup of patients. The FAST index is a relatively accessible tool that, due to its non-invasive nature, could be an alternative to liver biopsy for decision-making when starting specific therapy with action at histological liver changes in NASH.

Funding

The resources used in this study were from the hospital without any additional financing

Declaration of interest

The authors declare no potential conflicts of interest.

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