Role of Shear Wave Elastography in Staging Liver Fibrosis in Diabetic and Cardiac Patients

Abstract

Background: Liver fibrosis is a progressive consequence of chronic liver injury, particularly in individuals with metabolic disorders such as diabetes mellitus and cardiovascular diseases. Despite the growing prevalence of these conditions, early detection of liver fibrosis remains challenging due to the invasive nature of liver biopsy. This study addresses the need for reliable, non-invasive techniques to stage liver fibrosis in high-risk populations. Objective: To assess the role of Shear Wave Elastography (SWE) in staging liver fibrosis and hepatic steatosis in patients with diabetes and cardiac conditions, and to evaluate the association between comorbidities and liver stiffness and steatosis levels. Methods: This was a cross-sectional observational study conducted at the Liver Clinic in Muslim Town, Lahore, Pakistan, including 284 adult patients (n = 284) with a history of diabetes, cardiac disease, or both. Patients with hepatitis A, B, or C were excluded. SWE was performed using the Canon Aplio i600 system, and CAP scoring was used to assess steatosis. Ethical approval was obtained from the Institutional Review Board, and all procedures complied with the Declaration of Helsinki. Data were analyzed using SPSS version 25, applying descriptive statistics and Chi-square tests. Results: Among 284 patients, 28.9% exhibited advanced fibrosis (F3–F4), and 57% showed moderate-to-severe steatosis (S2–S3). The highest prevalence of fibrosis and steatosis was observed in patients with both diabetes and hypertension. A statistically significant association was found between metabolic comorbidities and elevated liver stiffness and CAP scores (p < 0.05), reinforcing the clinical utility of SWE in early fibrosis detection. Conclusion: SWE is a non-invasive, effective diagnostic modality for staging liver fibrosis in diabetic and cardiac patients. Its integration into routine screening can enhance early identification, guide timely interventions, and mitigate long-term hepatic complications in high-risk populations.