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- 저자 : ( Naresh Pokhrel ) (검색결과 1 건)
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Hidden Risk of Liver Disease in Type 2 Diabetes Population
( Sushant Pokhrel ),( Naresh Pokhrel ),( Bashu Dev Pardhe ),( Anit Lamichhane ),( Rakesh Pokhrel ),( Mahendra Prasad Bhatt ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: This study aimed to find the association of liver biomarker with diabetes population. Also, this study focused to find out the risk factors associated with liver disease in Nepalese diabetes patient. Methods: This study was carried out among 238 diabetes and 238 apparently healthy population who attended Modern diagnostic laboratory and Research center, Kathmandu, Nepal. HbA1c and fasting plasma glucose was measure to assess the diabetes population and glycemic control. Aspartate to platelet ratio index (APRI), gamma-glutamyl transpeptidase to platelet ratio (GPR), fibrosis-4 index (FIB-4), and triglyceride and glucose index (TyG) were assess for prediction of hidden risk liver disease. Diabetic patient with higher than the cut-off value obtained from ROC curve analysis of different liver marker index were subjected to multivariate regression analysis to measure the independent risk factor for progression liver disease in different model. Results: Patient with poor glycemic control had a significantly higher level of APRI (P=0.05), GPR (P=0.039), and TyG (P<0.001). Higher HbA1c showed significantly positive correlation with APRI (r=0.154, P=0.017), GPR (r=0.203, P=0.002), FIB4 (r=0.132, P=0.042), and TyG (r=0.510, P<0.001) in diabetic population. The Area under ROC curve of GPR was 0.700 (0.654-0.747), APRI 0.839 (0.803-0.874), FIB-4 0.820 (0.783-0.857), and TyG 0.909 (0.882-0.874) with p-value <0.05. The cut-off value (sensitivity, specificity) of GPR was 0.227 (63.4%, 63%), APRI 0.241 (71.0%, 80.3%), FIB-4 1.65 (71.8%, 77.3%), and TyG 8.85 (79%, 93.3%) respectively. Triglyceride, AST, and GGT was independent risk factor followed same trend in different 4 model while HbA1c and ALT showed independent risk factor in 3 models. Conclusions: APRI, GPR, FIB4 and TyG can define the hidden risk liver disease in T2DM. The independent risk factors for progression of liver disease in those population are hypertriglyceridemia, higher AST, and higher GGT. Routinely screening for markers may prevent progression of liver disease in T2DM patients.
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