Tip 2 diabetes mellituslu hastalarda metabolik disfonksiyonla ilişkili steatotik karaciğer hastalığının değerlendirilmesi

Yıl 2025, Cilt: 15 Sayı: 1, 71 - 77, 27.03.2025

Hüseyin Ali Öztürk , Erdinc Gulumsek , Dilan Damla Ozturk , Fatih Necip Arici , Begüm Şeyda Avci , Bektaş Işık , Mehmet Can Erişen , Bercem Berent Kaya , İrfan Alişan , Cahit Dincer , Ahmet Gazi Mustan , Tayyibe Saler , Hilmi Erdem Sümbül

https://doi.org/10.31832/smj.1636384

Öz

Amaç: Diabetes mellitus (DM); metabolik disfonksiyonla ilişkili steatotik karaciğer hastalığı (MASLD) gelişimi ve hastalığın ilerlemesiyle ilişkilidir. Çalışmamızda iç hastalıkları kliniğimizde takip ettiğimiz tip 2 DM tanılı hastalarda karaciğer ultrason (USG) görüntülemesi, FIB-4 skoru ve fibroscan bulgularına göre MASLD ve fibrozis bulgularını değerlendirmeyi amaçladık.
Metod: Retrospektif ve kesitsel çalışmamıza, anamnez ve önceden yapılmış olan tetkiklerinde çalışmaya dâhil olmalarında engel bir durum teşkil etmeyen 1282 tip 2 DM tanılı hasta alındı. Hastaların sitemden abdomen USG görüntülemelerine bakıldı ve FIB-4 skoru hesaplandı. FibroScan® Mini 430 cihazı (Echosens, France) ile gerçekleştirilen karaciğer sertliği (LS) ölçümlerine bakıldı.
Bulgular: 1282 hastanın 474’ünde (36.9%) USG görüntülemesi yapılmış olup bu hastaların ise 341’inde (71.9%) MASLD tanısı konulmuştur. MASLD tanısı konulan 341 hastanın 45’inde FIB-4 skoru>1.3 idi. MASLD tanısı olan 341 hastanın 231’inde fibroscan görüntülemesi yapıldığı tespit edildi. 231 hastanın içerisinde 52 (22.5%) hastada LS ölçümleri >8 kPa idi
Sonuç: DM tanılı hastalarda ileri fibrozis ve artmış kardiyovasküler mortalite ve morbidite ile ilişkilendirilen MASLD’ın erken dönemde karaciğer USG ile taranmasını, FIB-4 skorunun ölçülmesini ve mümkün olan merkezlerde fibroscan ile LS değerlendirilmesini öneriyoruz.

Anahtar Kelimeler

diyabetes mellitus, fibroscan, FIB-4, MASLD, USG

Etik Beyan

Adana Şehir Eğitim ve Araştırma Hastanesi Etik Kurulu 02.01.2025 tarih ve 319 sayılı kararı ile çalışmayı onaylamıştır.

Evaluation of Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients with Type 2 Diabetes Mellitus

Öz

Aim: Diabetes mellitus (DM) is associated with the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). In our study, we aimed to evaluate the findings of MASLD and fibrosis according to liver ultrasound (USG) imaging, FIB-4 score and fibroscan findings in patients with type 2 DM followed in our internal medicine clinic.
Methods: In our retrospective and cross-sectional study, 1282 patients diagnosed with type 2 DM whose anamnesis and previous examinations did not constitute an obstacle for inclusion in the study were included. The abdominal USG imaging of the patients were analysed from the system and the FIB-4 score was calculated. Liver stiffness (LS) measurements were performed with FibroScan® Mini 430 device (Echosens, France).
Results: USG imaging was performed in 474 (36.9%) of 1282 patients and MASLD was diagnosed in 341 (71.9%) of these patients. FIB-4 score> was 1.3 in 45 of 341 patients diagnosed with MASLD. Fibroscan imaging was performed in 231 of 341 patients with MASLD. In 52 (22.5%) of 231 patients, LS measurements> were 8 kPa
Conclusion: We recommend early screening of MASLD, which is associated with advanced fibrosis and increased cardiovascular mortality and morbidity in patients with DM, with liver USG, measurement of FIB-4 score and evaluation of LS with fibroscan in centres where possible.

Anahtar Kelimeler

Diabetes mellitus, Fibroscan, FIB-4, MASLD, USG

Etik Beyan

Adana City Training and Research Hospital Ethics Committee approved the study with decision number 319 dated 02.01.2025.

Kaynakça

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