Boris Guiu, Presenter: Nothing to Disclose

Elodie Crevisy-Girod, Abstract Co-Author: Nothing to Disclose

Christine Binquet, Abstract Co-Author: Nothing to Disclose

Douraied Ben Salem MD, Abstract Co-Author: Nothing to Disclose

Denis Krause MD, Abstract Co-Author: Nothing to Disclose

Jean Pierre Cercueil MD, Abstract Co-Author: Nothing to Disclose

Bruno Verges, Abstract Co-Author: Nothing to Disclose

Patrick Hillon, Abstract Co-Author: Nothing to Disclose

Jean Michel Petit, Abstract Co-Author: Nothing to Disclose

The Steatotest, Fatty liver index (FLI) and hepatic steatosis index (HSI) are clinico-biological scores of steatosis validated in general or in selected populations. Serum adiponectin (s-adiponectin) and serum retinol binding protein 4 (s-RBP4) are adipokines which could predict liver steatosis. We investigated whether the Steatotest, FLI, HSI, s-adiponectin and s-RBP4 could be valid predictors for liver steatosis in type-2 diabetes using 3.0T MR spectroscopy.

We prospectively enrolled 118 consecutive type-2 diabetic patients in whom the Steatotest, FLI, HSI, s-adiponectin and s-RBP4 were assessed. Reference standard was proton magnetic resonance spectroscopy. Intraclass correlation coefficients (ICCs), Kappa-statistic measures of agreement, receiver operating characteristic (ROC) curves and the influence of nephropathy and renal function (eGFR) on serum adipokines levels were assessed.

Median LFC was 85 mg triglyceride/g liver tissue (range, 0–341). ICCs between Steatotest, FLI, HSI, s-adiponectin, s-RBP4 and spectroscopy were low: 0.337, 0.212, 0.206, -0.324 and 0.086, respectively. Using published cut-offs, there was little agreement between scores and spectroscopy (Kappa range: .036–0.193). The areas under the ROC curves demonstrated low discrimination abilities: 0.620(Steatotest), 0.607(FLI), 0.627(HSI), 0.643(s-adiponectin) and 0.514(s-RBP4). S-Adiponectin and s-RBP4 levels were strongly related to the presence of diabetic nephropathy (P=.0065 and P<.0001 respectively; Mann-Whitney). S-RBP4 highly correlated with eGFR (r=-0.47, P<.0001).  

The Steatotest, FLI, HSI, s-adiponectin, s-RBP4 are not valid predictors for steatosis in type-2 diabetic patients using 3.0T MR spectroscopy as reference standard. The treatment can strongly modify many biological parameters. Diabetic nephropathy and/or renal function influence adipokines levels. Further biomarkers of steatosis should be specifically validated in type-2 diabetic patients.

Proton MR spectroscopy remains the best non-invasive method to predict and quantify liver steatosis in type-2 diabetes.

Guiu, B, Crevisy-Girod, E, Binquet, C, Ben Salem, D, Krause, D, Cercueil, J, Verges, B, Hillon, P, Petit, J, Prediction for Liver Steatosis Using Noninvasive Markers in Type 2 Diabetes.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009845.html