The International Journal of Romanian Society of Endocrinology / Registered in 1938

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October - December 2022, Volume 18, Issue 4
Endocrine Care

Mitrovic B, Gluvic Z, Klisic A, Obradovic M, Macut D, Tomasevic R, Isenovic ER

A Non-Invasive Method for Estimating the Severity of Liver Steatosis and the Risk of Fibrosis in Non-Obese Type 2 Diabetes Patients with NAFLD

Acta Endo (Buc) 2022, 18 (4): 480-487
doi: 10.4183/aeb.2022.480

Context. Prognostic considerations include assessing the risk of liver fibrosis in people with nonalcoholic fatty liver disease (NAFLD). Objectives. This study evaluates the use of hematologic and metabolic parameters regarding liver steatosis and fibrosis scores (FLI and Fib-4) in non-obese type 2 diabetes mellitus (t2DM) patients with NAFLD. Methods. Subjects underwent abdominal ultrasound examinations, and FLI and Fib-4 scores were calculated to evaluate liver steatosis and the risk of liver fibrosis non-invasively: 61 non-obese NAFLD subjects with t2DM were included in the cohort study and were divided into 2 groups depending on the t2DM treatment regimen. Results. Fib-4 and WBC count demonstrated a significant inverse correlation (OR = 0.509, p = 0.007). WBC count had an R2 of 0.237, indicating that this marker could account for up to 23.7% of a variation in Fib-4. Fib- 4 and FFA had positive correlation which did not achieve statistically significant prediction (OR=7.122, p=0.062). Additionally, a significant prediction of HbA1c (OR=1.536, p=0.016) and haemoglobin (OR=1.071, p=0.020) for FLI was revealed. Conclusion. HbA1c and other haematological and metabolic parameters, such as haemoglobin and WBC, may be another non-invasive tool for determining whether nonobese NAFLD patients with t2DM are at risk of developing liver steatosis and fibrosis.

Keywords: liver fibrosis, liver biopsy, Fib-4, FLI score, NAFLD, t2DM.

Correspondence: Milan Obradovic MD, VINCA Institute of Nuclear Sciences - National Institute of the Republic of Serbia, University of Belgrade, Dept. of Radiobiology and Molecular Genetics, Mike Petrovica Alasa 12-14, Belgrade, Serbia, 11000, E-mail: