Diabetic and Non-Diabetic Non-Alcoholic Fatty Liver Disease Patients: Assessment Using Non-Invasive Diagnostic Tools

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Background: Non-alcoholic fatty liver disease (NAFLD) incidence is rapidly increasing.Objective: Our study aimed to assess diabetic and non-diabetic NAFLD using non-invasive imaging tools; conventional US, Chemical shift MRI, and MRE to evaluate the degree of liver steatosis and fibrosis.Patients and methods: In this case-control study, a total of 130 subjects including 90 NAFLD patients {50 diabetic (Group I) & 40 non-diabetic (Group II), as well as 40 controls (Group III) }, were enrolled.The mean age in the present study was 51.46 ± 7.54 years in group I, 48.40 ± 7.47 years in group II, and 49.55 ± 7.95 years in group III (controls).Most of our subjects were females (78%, 77.5%, and 65% in groups I, II, and III respectively).Assessment of liver steatosis was done using conventional US and chemical shift (in-phase and out-of-phase) MR imaging.Assessment of liver stiffness to detect the degree of fibrosis/cirrhosis was done using magnetic resonance enterography (MRE).Results: Diabetic NAFLD patients (group I) had a higher degree of liver steatosis (scores 2 and 3), measured by conventional US, compared to group II (non-diabetic NAFLD).Group I patients had a significantly higher degree of liver steatosis (p = 0.007), measured by chemical shift (in-phase and out-phase) MRI, compared to group II.Liver stiffness measurement by MRE was significantly higher (p = 0.038) in group I (Mean 2.88 ± 0.81 kPa) than in group II (mean 2.46 ± 0.71kPa).Liver fibrosis (≥ F2) was significantly higher (p = 0.021) in group 1 (20 of 50 patients (40%)) than in group II (7 of 40 patients (17.5%)).Conclusions: Current non-invasive imaging methods demonstrated their value as non-invasive imaging biomarkers to evaluate the degree of liver steatosis in NAFLD and its progression into fibrosis/cirrhosis.