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The EPSONIP (Evaluating Prevalence and Severity Of NAFLD In Primary care) trial is a longitudinal cohort study of patients with T2DM recruited from primary health care centers in Östergötland, Sweden. The latest MRI techniques will be used to quantify the amount of hepatic fat, inflammation, liver fibrosis and body composition. Each patient will be investigated twice with three years apart to determine patients with progressive disease.
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| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of fatty liver | Number of patients with fatty liver measured with MR-PDFF | 2020 |
| Prevalence of advanced liver disease | Number of patients with advanced liver disease (fibrosis stage > 2) | 2020 |
| The association between physical activity and advanced liver disease (fibrosis >2) | Liver fibrosis measured with MRE and liver biopsy. Physical activity measured with the international fitness scale (IFIS) | 2020 |
| The association between physical activity and advanced liver disease (fibrosis >2) | Liver fibrosis measured with MRE and liver biopsy. Physical activity measured with Actigraph GT3X (accelerometer) | 2020 |
| The association between fitness and advanced liver disease (fibrosis >2) | Liver fibrosis measured with MRE and liver biopsy. Fitness measured with the six minute walk test. | 2020 |
| Genetic factors associated with advanced liver disease (fibrosis >2) | Liver fibrosis measured with MRE and liver biopsy. Genes to be analyzed: PNPLA3, TM6SF2, MBOAT | 2020 |
| Measure | Description | Time Frame |
|---|---|---|
| Health economic model for disease management | Markow model | 2025 |
| Number of patients that develop symptoms of end-stage liver disease | Symptoms of end-stage liver disease (ascites, encepahopathy, varices, HCC) or liver related Death will be recorded through chart review |
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Inclusion Criteria:
Exclusion Criteria:
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Consecutively enrolled patients with diabetes type 2 in primary care.
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| Name | Affiliation | Role |
|---|---|---|
| Mattias Ekstedt, MD, PhD | LiU | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ekholmen primary health care centre | Linköping | Swedish | 58185 | Sweden | ||
| Åby primary health care centre |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41219835 | Derived | Bergram M, Kechagias S, Iredahl F, Balkhed W, Holmberg M, Dahlstrom N, Lundberg P, Nasr P, Ekstedt M, Radholm K. Microvascular complications of type 2 diabetes with or without MASLD: the EPSOMIP study, a primary care cohort study. BMC Prim Care. 2025 Nov 11;26(1):354. doi: 10.1186/s12875-025-03096-2. | |
| 33879084 | Derived |
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| ID | Term |
|---|---|
| D065626 | Non-alcoholic Fatty Liver Disease |
| ID | Term |
|---|---|
| D005234 | Fatty Liver |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
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Serum, Plasma, DNA, RNA, liver tissue
| 2030 |
| Norrköping |
| Sweden |
| Nasr P, Iredahl F, Dahlstrom N, Radholm K, Henriksson P, Cedersund G, Dahlqvist Leinhard O, Ebbers T, Alfredsson J, Carlhall CJ, Lundberg P, Kechagias S, Ekstedt M. Evaluating the prevalence and severity of NAFLD in primary care: the EPSONIP study protocol. BMC Gastroenterol. 2021 Apr 20;21(1):180. doi: 10.1186/s12876-021-01763-z. |