| Objective:To evaluate the extent of liver steatosis and fibrosis in patients of type 2diabetes mellitus(T2DM)and correlation between liver steatosis and fibrosis by FibroTouch technique.Methods:To collect 92 cases of T2DM patients diagnosed by the Second Hospital of Dalian Medical University from December 2016 to April 2017,46 cases were male and 46 cases were female,the age was between 31 and 87 years old,the average age was(63.4±6.7)years old,the average BMI was(26.9±3.8)kg/m~2.All the diagnosis of T2DM were conform to the standards which set by WHO.Exclusion criteria:(1)alcohol intake was more than 140g per week in male or more than 70g per week in female;(2)type 1 diabetes,unknown type of diabetes,gestational diabetes,and special type of diabetes;(3)viral hepatitis,drug-induced liver disease,autoimmune liver disease,schistosomiasis liver disease,hereditary liver disease and other liver diseases;(4)the specific diseases of fatty liver can be caused by external nutrition,hypothyroidism,Cushing’s syndrome and so on;(5)complications such as acute complications of diabetes mellitus,severe infection,end-stage renal disease,hematopathy and other metabolic disorders.92 cases of T2DM patients were enrolled and divided into two group:group A(46 cases,diabetic duration>10 years),23 cases were male and 23 cases were female,the age was between 37 and 87 years old,the average age was(64.3±6.9)years old,the average BMI was(21.7±3.4)kg/m~2;group B(46 cases,diabetic duration≤10 years),23 cases were male and 23 cases were female,the age was between 31 and77 years old,the average age was(62.6±6.5)years old,the average BMI was(26.7±4.2)kg/m~2;46 healthy subjects were enrolled as controls(group C),23 cases were male and 23 cases were female,the age was between 24 and 77 years old,the average age was(63.0±6.3)years old,the average BMI was(26.1±3.7)kg/m~2.There was no significant difference in gender,age and BMI(P>0.05).FibroTouch technique was used to measure the liver fat attenuation parameter(FAP)and liver stiffness measurement(LSM).The patient empty stomach,supine position,show right arm,and try to expand the intercostal space.First of all,the B probe was used to scan through the intercostal space of the FibroTouch,and the positioning was carried out to ensure that there were no ribs,large vessels,cysts and nodules within 8.5cm of the center of the probe center,and the liver essence was uniform.Then switch to elastic scanning probe in patients with anchor point close to rib clearance,instruct patients held her breath and probe vertically with the skin surface,when the pressure indicator shows as the center,M wave of layered homogeneous,A linear,elastic wave figure waveform parallel start measuring,measuring more than 10 times for same point success,success rate is more than 60%,the relative deviation is less than 33%,measured the FAP(dB/M)and LSM(kPa)of every groups.Results:The FAP and LSM of group A and group B were significantly larger than those of group C(all P<0.05);the FAP of group A was smaller than that of group B and the LSM of group A was larger than that of group B(all P<0.05).The degree of liver steatosis increased in group A and group B compared with that of group C(all P<0.05),and the degree of liver steatosis decreased in group A compared with that of group B(P<0.05);The degree of liver stiffness increased in group A and group B compared with that of group C(all P<0.05),and the degree of liver stiffness increased in group A compared with that of group B(P<0.05).There was a negative correlation between liver fibrosis and steatosis(r=-0.81,P<0.05).Conclusion:As the course of T2DM increases,the degree of liver steatosis decreases,the degree of liver stiffness increases.There was a negative correlation between liver fibrosis and steatosis.The fibrosis and steatosis of the liver in T2DM patients can be evaluated non-invasively,conveniently and objectively by FibroTouch technique,which provides objective basis for early diagnosis and treatment of clinic,and has an important clinical value. |
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