Comparison of Different Non-Invasive Hepatic Fibrosis Evaluation Criteria for the Evaluation of Hepatic Fibrosis in Patients with Type 2 Diabetes Mellitus Combined with Non-Alcoholic Fatty Liver Disease

Objective:To compare different non-invasive hepatic fibrosis evaluation criteria for the evaluation of hepatic fibrosis in patients with type 2 diabetes mellitus(T2DM)combined with non-alcoholic fatty liver disease(NAFLD).Methods:A total of996 patients(male 578,female 418)definitely diagnosed with T2DM,who were simultaneously identified as NAFLD by ultrasonography,were involved in the analysis.The venous fasting blood was collected from patients,and blood routine and hepatic enzymes were evaluated.Aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio,FIB-4index,BARD score,AST to platelet ratio index(APRI)and NAFLD fibrosis scores(NFS)were calculated.NFS was set as the evaluation criterium for hepatic fibrosis.The correlations between the other indexes and the NFS were compared with correlation analysis.As the next step,consistency of these indexes was evaluated by Bland-Altman method.Results:AST/ALT ratio,FIB-4index,BARD score and APRI ratio had linear positive correlation with NFS among male and female patients with T2DM combined with NAFLD.Furthermore,the most significant correlation was observed between FIB-4 index and NFS(r=0.619,P0.01).Bland-Altman analysis indicated that AST/ALT ratio and FIB-4 index were highly consistent with NFS,and the FIB-4 index was the best among the indexes.Conclusions:AST/ALT ratio and FIB-4index can be used to identify whether there is hepatic fibrosis in patients with T2DM combined with NAFLD.