Estimated Prevalence of Advanced Hepatic Fibrosis by Elastography in Patients with Type 2 Diabetes

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. The grade of hepatic fibrosis is known to be closely associated with over-all or liver-related mortality in NAFLD. In order to detect early stage of hepatocellular carcinoma (HCC), it is essential to identify advanced hepatic fibrosis in NAFLD. To avoid invasive liver biopsies, several modalities have developed for evaluating hepatic fibrosis, including elastography (FibroScan and magnetic resonance elastography) and noninvasive tests (NITs) such as fibrosis-4 index and NAFLD fibrosis score. Patients with type 2 diabetes is twice at higher risk for incident HCC compared to the non-diabetic population. Although type 2 diabetes is also associated with fibrosis progression of NAFLD, the precise prevalence of advanced hepatic fibrosis in type 2 diabetes remains unknown. To detect or prevent the development of HCC in type 2 diabetes, mining patients with advanced fibrosis (stage 3/4) is important. It is estimated that approximately 17% of patients with type 2 diabetes receiving liver biopsies had advanced fibrosis. Population-based data are essential because of excluding selection bias. In this review, we review estimated prevalence of advanced hepatic fibrosis in patients with type 2 diabetes by using non-invasive elastography.