Objective: Considering that type 2 diabetes mellitus (T2DM) may be one of the strongest risk factors for promoting nonalcoholic steatosis to advanced fibrosis, we aimed to investigate the prevalence of steatosis and fibrosis, and identify risk factors associated with compensated advanced chronic liver diseases (cACLD) among Chinese adults with T2DM in the community.

Methods: This is a prospective large-scale study covering six cities in China. We enrolled T2DM patients registered in the community between June 2021 and November 2022, and collected baseline demographics and comorbidities. Furthermore, controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were measured by vibration-controlled transient elastography to assess hepatic steatosis and fibrosis.

Results: A total of 3,196 patients with T2DM in the community were included in the study. The prevalence of steatosis (CAP ≥248 dB/m) and cACLD (LSM ≥10 kPa) was 60% and 9%, respectively. Additionally, the prevalence of mild fibrosis (F1), moderate fibrosis (F2), severe fibrosis (F3) and cirrhosis (F4) was 12%, 7%, 7% and 3%, respectively. The distribution of mild (S1), moderate (S2), and severe (S3) steatosis was 14%, 8%, and 38%, respectively. Furthermore, 5% of patients with non-obesity (body mass index <30 kg/m2) nonalcoholic fatty liver disease related cACLD (12/252) presented with clinically significant portal hypertension (LSM ≥25 kPa) according to the renewing Baveno VII consensus, indicating a high risk of hepatic decompensation. In the multivariate logistic regression model, age>50 years, body mass index, and the presence of hypertension were independent predictors of cACLD among patients with T2DM in the community.

Conclusions: We found a considerable prevalence of steatosis and cACLD in community patients with T2DM. It is imperative to screen for these conditions to facilitate further intervention among T2DM patients.

Disclosure

X.Qi: None. R.He: None. C.Liu: None. C.Sun: None. G.Teng: None.

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