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PTH-138 Screening Diabetic Patients for Liver Fibrosis in a Primary Care Diabetes Clinic
  1. B Deans1,
  2. F Crimmons2,
  3. D Al Dulaimi1,
  4. P Clamp2
  1. 1Gastroenterology, Alexandra Hospital, Worcestershire Acute Hospitals NHS Trust, Redditch
  2. 2St Johns Surgery, BHI Parkside, Bromsgrove, UK

Abstract

Introduction Patients attending for routine review at a primary care diabetes clinic were screened for advanced fibrosis using a NAFLD fibrosis score calculator.

Methods The NAFLD Fibrosis Score online calculator (http://nafldscore.com/) has been developed to identify patients that are at significant risk of having advanced fibrosis using body mass index, serum ALT, AST, platelet count, diagnosis of diabetes and age as parameters.1 We prospectively screened consecutive patients attending for routine review at a primary care diabetes clinic between June and December 2015. Advanced fibrosis was predicted using high cut-off score (>0.676; with previously validated Positive Predictive Value 90%) or excluded for low cut-off score (<−1.455; Negative Predictive Value 93%). Patients with Type 1 and Type 2 diabetes were included. Statistical analysis was performed with Pearson’s and Chi Squared test.

Results 208 patients were screened, 126 males and 82 females, with a median age of 66 years (range 22–93 years). 21% of patients (29 male and 17 female) with a median age of 76, had a NAFLD Fibrosis score predicting a significant risk of advanced fibrosis and identifying them as appropriate for referral to secondary care. A NAFLD score predicting a significant risk of advanced fibrosis increased with age: 5.6% (1/ 18) of patients aged less than 50, 9.5% (4/42) of patients aged 50–59 years, 12.5% (7/56) of patients aged 60–69, 35.1% (20/57) aged 70–79 and 56% (14/25) of patients aged 80 years and older. Advanced fibrosis was predicted for 23% male (29/126) and 21% females (17/82) patients. Advanced fibrosis was excluded in 13.5% patients (28/208). As expected, there was a moderate positive correlation between NAFLD score and age (r = 0.56). There was no significant difference in the proportion of male or female patients with advanced fibrosis (p = 0.7).

Conclusion It is practical to routinely screen patients for liver fibrosis secondary to NAFLD within a primary care diabetes clinic using the NAFLD fibrosis score calculator and identify a significant proportion of patients at significant risk of advanced fibrosis.

Reference 1 Angulo P, Hui JM, Marchesini G, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 2007;45(4):846-854

Disclosure of Interest None Declared

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