Abstract
Background & Aims
Liver stiffness is an indirect marker of liver fibrosis, which predicts clinical outcomes
in patients with nonalcoholic fatty liver disease (NAFLD). The aim of the present
systematic review and meta-analysis is to summarize evidence on the prevalence of elevated liver stiffness in
patients with diabetes.
Methods
We systematically searched PubMed-MEDLINE and Scopus from inception to May 2022 for
observational studies reporting the prevalence of elevated liver stiffness diagnosed
by vibration controlled transient elastography (VCTE) in adult patients with either
type 1 (T1D) or type 2 diabetes (T2D). Prevalence values from individual studies were
meta-analyzed using random effects models. Subgroup and sensitivity analyses were performed
to identify potential sources of heterogeneity.
Results
Of the 428 titles initially scrutinized, 29 studies fulfilled the criteria and were
included, providing data on 390 patients with T1D and 10,487 patients with T2D. Prevalence
rates of elevated liver stiffness were 5.2% (95% CI 1.1–9.2) in patients with T1D
and 19.8% (95% CI 16.8–22.8) in patients with T2D. In studies performed in patients
with T2D, multivariate meta-regression analysis showed that higher body mass index, higher age, a higher proportion
of males, lower VCTE cut-off and Asian ethnicity were associated with increased prevalence
rates. This model explained 32.7% of the observed heterogeneity. No signs of publication
bias were identified by visual inspection of the funnel plot or by Egger’s test.
Conclusions
This meta-analysis indicates that 1 in 20 patients with T1D and 1 in 5 patients with T2D has
elevated liver stiffness, indicative of potential significant or advanced liver fibrosis.
Keywords
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Article info
Publication history
Published online: July 04, 2022
Accepted:
July 1,
2022
Received in revised form:
June 26,
2022
Received:
June 9,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
