# Association of liver elastography measurements with poor glycaemic control in elderly patients with type 2 diabetes

## TL;DR

This study finds that liver stiffness measured by elastography is linked to poor blood sugar control in elderly type 2 diabetes patients.

## Contribution

The study identifies liver stiffness as an independent predictor of poor glycaemic control in elderly type 2 diabetes patients.

## Key findings

- Higher liver stiffness is associated with lower time in range (TIR) for glucose levels.
- A liver stiffness threshold of 6.8 kPa is suggested to identify patients with poor glycaemic control.

## Abstract

The relationship between liver health and glycaemic control in elderly
patients with diabetes remains poorly understood. In this study, the value
of liver elastography in identifying associations with poor glycaemic
control among elderly patients with type 2 diabetes mellitus was
investigated.

In total, 90 elderly patients (aged ≥ 60 years) with type 2 diabetes
mellitus were enrolled in this prospective observational study. All
participants underwent liver elastography using FibroScan®
and continuous glucose monitoring (CGM). Liver stiffness measurements (LSMs)
and the controlled attenuation parameter (CAP) were obtained. Glycaemic
control was assessed through multiple parameters, including the time in
range (TIR), time above range (TAR), glycaemic variability, and mean glucose
levels. Poor glycaemic control was defined as a TIR < 70%. The mean age
of the participants was 64.0 ± 10.5 years, with 65.6% being female.
The mean liver stiffness was 6.1 ± 7.8 kPa, and the mean CAP was
266.0 ± 54.7 dB/m.

Patients with higher liver stiffness (>8.0 kPa) had a significantly lower
TIR (68.7% versus 83.5%, p<0.001) than those with normal liver stiffness
(<5.5 kPa). LSMs were strongly negatively correlated with the TIR (r =
-0.42, p < 0.001) and positively correlated with the mean glucose level
(r = 0.38, p < 0.001). Multivariate analysis revealed that increased
liver stiffness was independently associated with poor glycaemic control
(adjusted OR = 1.28, 95% CI: 1.14-1.44; p < 0.001).

ROC analysis revealed an exploratory LSM cut-off value of 6.8 kPa for
association with poor glycaemic control (AUC = 0.76; sensitivity = 71.2%;
specificity = 78.9%). LSMs via transient elastography are independently
associated with poor glycaemic control in elderly patients with type 2
diabetes. An LSM threshold of 6.8 kPa may help identify patients who are
more likely to present with poor glycaemic control.