New Screening Method Shows Promise for Early Detection of Liver Disease in Type 2 Diabetics
A groundbreaking study suggests a revolutionary approach to detecting advanced liver disease in individuals with type 2 diabetes (T2D): simultaneous screening during routine retinal exams. This innovative method could significantly improve early diagnosis adn treatment, potentially saving lives.
How the Study Worked
Researchers in Stockholm conducted a cross-sectional study, offering liver stiffness tests alongside standard retinal scans to patients with T2D. The tests used vibration-controlled transient elastography (VCTE) to measure liver stiffness, a key indicator of fibrosis. A controlled attenuation parameter (CAP) measured the presence of metabolic dysfunction-associated steatotic liver disease (MASLD),a common condition among T2D patients. The study excluded individuals with type 1 diabetes, pregnancy, pre-existing liver disease, high alcohol consumption, or language barriers.
Key Findings
Of 1,301 eligible participants, a significant 77.2% (1,005 individuals) agreed to the combined screening. Initial results revealed a high prevalence of MASLD (504 participants) and concerning levels of liver stiffness. However, a follow-up VCTE, conducted an average of 39 days later, showed a substantial decrease in the number of participants with elevated liver stiffness, suggesting a potential for false positives in the initial screening.
Study authors acknowledged this concern, stating, “This risk must be considered if implementing this method into clinical routine.”
Experts from the University of Milano Bicocca offered insight in an accompanying editorial, suggesting that “only doing a VCTE in patients with an elevated [fibrosis-4] score, by increasing pretest probability of fibrosis, might lead to a higher positive predictive value than a single VCTE without confirmation.”
Implications for U.S. Healthcare
This research holds significant implications for the U.S.healthcare system,where type 2 diabetes is a widespread concern. Early detection of liver disease is crucial, as it can often be asymptomatic in its early stages.This combined screening approach could revolutionize preventative care, allowing for earlier intervention and potentially reducing the burden of advanced liver disease.
Study Limitations
The study had some limitations. Missing laboratory data from initial visits, partly due to a lack of on-site blood testing, affected the analysis.The COVID-19 pandemic may have influenced participation rates. Variations in VCTE devices used across different sites could also have impacted results. the researchers did not confirm advanced fibrosis through liver biopsy in all cases.
Funding and Disclosures
The study received funding from Gilead Sciences, Pfizer, Region stockholm, and other sources. One author disclosed financial ties to several pharmaceutical companies.
The study was led by Andrea Lindfors, MD, from the Karolinska University Hospital in Stockholm, Sweden, and published in the Lancet Gastroenterology & Hepatology.
