studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1275A
2189
Prevalence of non-alcoholic fatty liver disease (NAFLD)
and its subtypes obtained by liver biopsy in patients
with type 2 diabetes not selected by ultrasound and/or
aminotransferase levels
Lilian M. Silva 2 , Fatima F. Figueiredo 2,3 , Frederico F. Campos 4 ,
Marcio Q. Miguez 2 , Valéria P. Lanzoni 5 , Marilia B. Gomes 6 , Carlos
Terra 2 , Hugo Perazzo 1 , Renata M. Perez 2,7 ; 1 National Institute
of Infectious Diseases Evandro Chagas, Rio de Janeiro, Brazil;
2 Liver Unit, University of the State of Rio de Janeiro, Rio de Janeiro,
Brazil; 3 Internal Medicine, Federal University of Rio de Janeiro,
Rio de Janeiro, Brazil; 4 Pathology, University of the State of Rio
de Janeiro, Rio de Janeiro, Brazil; 5 Pathology, Federal University
of São Paulo, São Paulo, Brazil; 6 Diabetology, University of the
State of Rio de Janeiro, Rio deJaneiro, Brazil; 7 D’Or Institute for
Research and Education, Rio de Janeiro, Brazil
Background: Non-alcoholic fatty liver disease (NAFLD) and
its severe form, steatohepatitis (NASH), have been described
as highly prevalent in patients with metabolic diseases. The
aims were: (i) to estimate the prevalence of NAFLD and its
spectrum by liver biopsy in type 2 diabetes patients; (ii) to
quantify steatosis and fibrosis; (iii) to identify variables predictive
of NASH and fibrosis. Patients and methods: Patients with
type 2 diabetes were submitted to percutaneous liver biopsy
regardless of alanine aminotransferase (ALT) levels or abdominal
ultrasound results. The exclusion criteria were presence of
other chronic liver disease or serious systemic diseases; coagulation
disturbances; morbid obesity; alcohol abuse; use of
hepatotoxic drugs; pregnancy; or refusal to participate. Slides
of liver biopsy were evaluated by two independent pathologists
using the NASH Activity Score. Factors associated with NASH
and significant fibrosis (stage F≥2) were defined by logistic
regression analysis. Results: 85 patients [82% female, mean
age=54 yrs, mean BMI=31 Kg/m 2 , 61% with normal ALT,
53% treated by insulin] were included. Median (range) liver
specimen length was 30 (25-75) mm. Prevalence of NAFLD in
type 2 diabetes was 92% [n=78/85], 54% (n=42) of whom
with simple steatosis and 46% (n=36) with NASH. Severe steatosis
(>33% of hepatocytes) was more prevalent in patients
with NASH compared to those with simple steatosis (65% vs
7%; p