DiabetesLiver score: A non-invasive algorithm for advanced liver fibrosis and liver-related outcomes in type 2 diabetes mellitus population.

IF 12.8 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Med Pub Date : 2025-05-13 DOI:10.1016/j.medj.2025.100700

Chuan Liu, Jie Shen, Jie Li, Zhihui Li, Ming-Hua Zheng, Hua Bian, Xiqiao Zhou, Wenjing Ni, Zhongji Meng, Jiaojian Lv, Yijun Tang, Xuan Liang, Min Li, Taolong Zhou, Heng Wan, Yuping Chen, Yuxia Qi, Yuli Ge, Yan Wang, Wen-Yue Liu, Mingxing Huang, Shanghao Liu, Xiaomei Wang, Mingfeng Xia, Xuefeng Li, Yuehua Wang, Xinjie Li, Xiaoxiong Hu, Yan Wu, Huimin Ying, Jing He, Fengmei Wang, Wei Yan, Huili Wu, Qingge Zhang, Weimin Jiang, Yan Huang, Yudong Zhang, Hongliang He, Xiaofeng Wu, Yuwei Zhang, Ling Li, Terry Cheuk-Fung Yip, Gao-Jun Teng, Xiaolong Qi

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引用次数: 0

Abstract

Background: This study aimed to develop and validate a non-invasive model for screening advanced liver fibrosis and predicting liver-related outcomes in patients with type 2 diabetes mellitus (T2DM).

Methods: This study included patients with T2DM from five tertiary hospitals for the development and internal validation of a non-invasive model. Advanced liver fibrosis was defined as a liver stiffness measurement ≥12 kPa. An external validation cohort was obtained from the National Health and Nutrition Examination Survey (NHANES), and the model's predictive performance for hepatocellular carcinoma (HCC) and liver-related mortality was assessed in the UK Biobank.

Findings: In total, 28,197 patients with T2DM were enrolled. In the derivation cohort (n = 1,129), waist circumference, alanine aminotransferase, aspartate aminotransferase, platelet count, and albumin were identified as independent risk factors for advanced fibrosis and were fit to develop the "DiabetesLiver score." The area under the curve (AUC) was 0.835 (95% confidence interval [CI]: 0.781-0.890), significantly higher than the AUCs of non-invasive tests (all p < 0.01). It maintained high AUCs of 0.870 and 0.823 in the internal validation (n = 1,000), and NHANES cross-sectional (n = 1,432) cohorts, respectively. A dual cutoff of 2.39 and 3.99 with sensitivity ≥90% and specificity ≥90%, respectively, was used to classify patients into low-, middle-, and high-risk groups. In the UK Biobank cohort (n = 24,636), the high-risk group had an elevated risk of liver-related outcomes.

Conclusions: The DiabetesLiver score demonstrated good performance in identifying advanced liver fibrosis and the development of liver-related events in the T2DM population.

Funding: National Natural Science Foundation.

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糖尿病肝脏评分：2型糖尿病患者晚期肝纤维化和肝脏相关预后的一种无创算法。

背景：本研究旨在建立和验证一种非侵入性模型，用于筛查2型糖尿病（T2DM）患者的晚期肝纤维化和预测肝脏相关预后。方法：本研究纳入了来自五家三级医院的T2DM患者，用于开发和内部验证非侵入性模型。晚期肝纤维化定义为肝硬度≥12 kPa。从国家健康和营养检查调查（NHANES）获得了一个外部验证队列，并在英国生物银行评估了该模型对肝细胞癌（HCC）和肝脏相关死亡率的预测性能。研究结果：共纳入28,197例T2DM患者。在衍生队列（n = 1129）中，腰围、丙氨酸转氨酶、天冬氨酸转氨酶、血小板计数和白蛋白被确定为晚期纤维化的独立危险因素，适合制定“糖尿病肝脏评分”。曲线下面积（AUC）为0.835(95%可信区间[CI]: 0.781 ~ 0.890)，显著高于无创检查的AUC（均p < 0.01）。在内部验证（n = 1000）和NHANES横断面（n = 1432）队列中，auc分别为0.870和0.823。采用2.39和3.99的双截止值（敏感度≥90%，特异性≥90%）将患者分为低、中、高风险组。在英国生物银行队列（n = 24,636）中，高风险组肝脏相关结果的风险升高。结论：在T2DM人群中，DiabetesLiver评分在识别晚期肝纤维化和肝脏相关事件发展方面表现良好。资助项目：国家自然科学基金。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Med MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

17.70

自引率

0.60%

发文量

102

期刊介绍： Med is a flagship medical journal published monthly by Cell Press, the global publisher of trusted and authoritative science journals including Cell, Cancer Cell, and Cell Reports Medicine. Our mission is to advance clinical research and practice by providing a communication forum for the publication of clinical trial results, innovative observations from longitudinal cohorts, and pioneering discoveries about disease mechanisms. The journal also encourages thought-leadership discussions among biomedical researchers, physicians, and other health scientists and stakeholders. Our goal is to improve health worldwide sustainably and ethically. Med publishes rigorously vetted original research and cutting-edge review and perspective articles on critical health issues globally and regionally. Our research section covers clinical case reports, first-in-human studies, large-scale clinical trials, population-based studies, as well as translational research work with the potential to change the course of medical research and improve clinical practice.