TY - JOUR
T1 - Implementation of a liver health check in people with type 2 diabetes
AU - Abeysekera, Kushala W. M.
AU - Valenti, Luca
AU - Younossi, Zobair
AU - Dillon, John F.
AU - Allen, Alina M.
AU - Nourredin, Mazen
AU - Rinella, Mary E.
AU - Tacke, Frank
AU - Francque, Sven
AU - Ginès, Pere
AU - Thiele, Maja
AU - Newsome, Philip N.
AU - Guha, Indra Neil
AU - Eslam, Mohammed
AU - Schattenberg, J. rn M.
AU - Alqahtani, Saleh A.
AU - Arrese, Marco
AU - Berzigotti, Annalisa
AU - Holleboom, Adriaan G.
AU - Caussy, Cyrielle
AU - Cusi, Kenneth
AU - Roden, Michael
AU - Hagström, Hannes
AU - Wong, Vincent Wai-Sun
AU - Mallet, Vincent
AU - Castera, Laurent
AU - Lazarus, Jeffrey V.
AU - Tsochatzis, Emmanuel A.
N1 - Publisher Copyright: © 2023 Elsevier Ltd
PY - 2024/1/1
Y1 - 2024/1/1
N2 - As morbidity and mortality related to potentially preventable liver diseases are on the rise globally, early detection of liver fibrosis offers a window of opportunity to prevent disease progression. Early detection of non-alcoholic fatty liver disease allows for initiation and reinforcement of guidance on bodyweight management, risk stratification for advanced liver fibrosis, and treatment optimisation of diabetes and other metabolic complications. Identification of alcohol-related liver disease provides the opportunity to support patients with detoxification and abstinence programmes. In all patient groups, identification of cirrhosis ensures that patients are enrolled in surveillance programmes for hepatocellular carcinoma and portal hypertension. When considering early detection strategies, success can be achieved from applying ad-hoc screening for liver fibrosis in established frameworks of care. Patients with type 2 diabetes are an important group to consider case findings of advanced liver fibrosis and cirrhosis, as up to 19% have advanced fibrosis (which is ten times higher than the general population) and almost 70% have non-alcoholic fatty liver disease. Additionally, patients with type 2 diabetes with alcohol use disorders have the highest proportion of liver-related morbidity of people with type 2 diabetes generally. Patients with type 2 diabetes receive an annual diabetes review as part of their routine clinical care, in which the health of many organs are considered. Yet, liver health is seldom included in this review. This Viewpoint argues that augmenting the existing risk stratification strategy with an additional liver health check provides the opportunity to detect advanced liver fibrosis, thereby opening a window for early interventions to prevent end-stage liver disease and its complications, including hepatocellular carcinoma.
AB - As morbidity and mortality related to potentially preventable liver diseases are on the rise globally, early detection of liver fibrosis offers a window of opportunity to prevent disease progression. Early detection of non-alcoholic fatty liver disease allows for initiation and reinforcement of guidance on bodyweight management, risk stratification for advanced liver fibrosis, and treatment optimisation of diabetes and other metabolic complications. Identification of alcohol-related liver disease provides the opportunity to support patients with detoxification and abstinence programmes. In all patient groups, identification of cirrhosis ensures that patients are enrolled in surveillance programmes for hepatocellular carcinoma and portal hypertension. When considering early detection strategies, success can be achieved from applying ad-hoc screening for liver fibrosis in established frameworks of care. Patients with type 2 diabetes are an important group to consider case findings of advanced liver fibrosis and cirrhosis, as up to 19% have advanced fibrosis (which is ten times higher than the general population) and almost 70% have non-alcoholic fatty liver disease. Additionally, patients with type 2 diabetes with alcohol use disorders have the highest proportion of liver-related morbidity of people with type 2 diabetes generally. Patients with type 2 diabetes receive an annual diabetes review as part of their routine clinical care, in which the health of many organs are considered. Yet, liver health is seldom included in this review. This Viewpoint argues that augmenting the existing risk stratification strategy with an additional liver health check provides the opportunity to detect advanced liver fibrosis, thereby opening a window for early interventions to prevent end-stage liver disease and its complications, including hepatocellular carcinoma.
UR - http://www.scopus.com/inward/record.url?scp=85178997915&partnerID=8YFLogxK
U2 - 10.1016/S2468-1253(23)00270-4
DO - 10.1016/S2468-1253(23)00270-4
M3 - Review article
C2 - 38070521
SN - 2468-1253
VL - 9
SP - 83
EP - 91
JO - The Lancet Gastroenterology and Hepatology
JF - The Lancet Gastroenterology and Hepatology
IS - 1
ER -