Fatty liver warning for diabetics

Local | Carain Yeung 22 Jul 2016

Diabetics have a 70 percent chance of having a fatty liver, with one in five facing prospects of developing severe liver fibrosis or cirrhosis, a Chinese University of Hong Kong study has found.

Alice Kong Pik-shan, an associate professor at CUHK's endocrinology and diabetes division, said the study suggests there should be regular screening tests for diabetes patients to identify fatty livers.

"This is important as a fatty liver and severe liver fibrosis or cirrhosis slowly affects the patient and the cases are often without symptoms," she said.

Researchers assessed 1,918 Prince of Wales Hospital diabetes patients in 2013 and 2014. A screening test found that 73 percent had fatty livers and 18 percent cirrhosis. That is in sharp contrast to healthy people, with just 27 percent with fatty livers and 4 percent with cirrhosis.

A Ms Cheng, 47, said she had been overweight since she gave birth to her first child 24 years ago and was diagnosed with diabetes in 2006. After about eight years, Cheng was found to have severe fibrosis. She said the diagnosis motivated her to eat healthier foods and exercise. As a result, her weight dropped from 82 kilograms to 68kg.

Henry Chan Lik-yuen, director of the university's Institute of Digestive Disease, said that fatty livers can cause inflammation which can scar the liver, eventually leading to cirrhosis and other complications.

"Relevant studies found that a fatty liver can somehow be 'reversed' as shown in the group of patients who successfully lost at least two inches around their waists in three years," Chan said.

While it is known that early detection benefits treatment, whether to send patients for screening tests remains controversial within the medical sector internationally, according to Chan. He said that an ultrasound scan used to make the diagnosis, but its accuracy is low as it cannot detect a fatty liver unless fat makes up at least a third of the liver. It is also not sensitive enough to tell early-stage liver fibrosis.

Chan said that the FibroScan machine, which features the latest transient elastography technology, performs much better and its accuracy in detecting a fatty liver is as high as 60 to 90 percent and fibrosis about 95 percent.

The machine is not available in every hospital since it is not a required medical procedure under the existing guidelines, Chan said. Kong said that it costs about HK$1,000 for a FibroScan test at the Prince of Wales Hospital.

About 10 percent of Hongkongers are diabetic. The study found that diabetic patients, with a higher body mass index and cholesterol level and poor diabetes control, are more prone to getting a fatty liver, said CUHK gastroenterology and hepatology professor Vincent Wong Wai-sun.

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