DURATION OF TYPE 2 DIABETES AS A CLINICAL PREDICTOR OF LIVER FIBROSIS IN PATIENTS WITH METABOLIC DYSFUNCTION ASSOCIATED STEATOTIC LIVER DISEASE

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.101992

Daniza Alexandra Contreras de los Santos , Invis Perez Mendez , Omar Ebrahim Ibrahim

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Abstract

Introduction and Objectives

Metabolic dysfuntion associated liver disease (MASLD) is highly prevalent in patients with type 2 diabetes mellitus (T2DM), and fibrosis progression is the main prognostic factor. However, clinical predictors of fibrosis remain unclear. Diabetes duration has been suggested as a potencial independent risk factor.

To assess the association between T2DM duration and liver fibrosis estimated by the FIB-4 index and liver stiffness measurement (LSM) in Dominican patients with MASLD.

Materials and Methods

A retrospective cohort study was conducted including 127 adults with MASLD, diagnosed based on hepatic steatosis detected by abdominal ultrasound and coexisting T2DM, following international criteria. Patients were evaluated at a tertiary care center in the Dominican Republic between July 2024 and January 2025.

The FIB-4 was calculated using AST, ALT, platelet count, and age.LSM by transient elastography was available 32 cases. Diabetes duration was extracted from medical records and categorized into five groups (0-5, 6-10, 11-15, 16-20 y >20 years). Spearman correlation assessed associations between diabetes duration, FIB-4, and LSM. Nonparametric test compared fibrosis by duration groups. Significance was set at p<0.05.

Results

Mean age was 56.6 ± 13.9 years; 63 % were women. FIB-4 showed moderate correlation with T2DM duration (ρ=0.26, p=0.005) and age (ρ=0.49, p<0.001). In patient aged 35-65 years, FIB-4 strongly correlated with LSM (ρ=0.77, p<0.001). According to FIB-4 classification, 63.8% were low-risk (<1.3), 32.3% intermediate-risk (1.3-2.67), and 3.9% high-risk (>2.67) for advanced fibrosis.

Conclusions

T2DM duration moderately correlates with FIB-4, especially in mind-aged adults, supporting its role in fibrosis risk models.

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2型糖尿病病程作为代谢功能障碍相关脂肪变性肝病患者肝纤维化的临床预测因子

代谢功能障碍相关肝病（MASLD）在2型糖尿病（T2DM）患者中非常普遍，纤维化进展是主要的预后因素。然而，纤维化的临床预测因素仍不清楚。糖尿病病程被认为是一个潜在的独立危险因素。通过FIB-4指数和肝硬度测量（LSM）评估多米尼加MASLD患者的T2DM病程与肝纤维化之间的关系。材料与方法采用回顾性队列研究，纳入127例成人MASLD，根据腹部超声检查肝脏脂肪变性诊断并合并T2DM，遵循国际标准。2024年7月至2025年1月期间，患者在多米尼加共和国的一家三级保健中心接受评估。FIB-4通过AST、ALT、血小板计数和年龄计算。利用瞬态弹性成像对32例LSM进行了分析。从病历中提取糖尿病病程，将其分为5组（0-5岁、6-10岁、11-15岁、16-20岁）。Spearman相关性评估糖尿病病程、FIB-4和LSM之间的关系。非参数检验比较病程组间的纤维化。显著性设置为p<；0.05。结果患者平均年龄56.6±13.9岁；63%是女性。FIB-4与T2DM病程（ρ=0.26, p=0.005）和年龄（ρ=0.49, p= 0.001）有中度相关性。在35-65岁的患者中，FIB-4与LSM密切相关（ρ=0.77, p<0.001）。根据FIB-4分级，63.8%为低危（<1.3）， 32.3%为中危（< 2.67）， 3.9%为高危（>2.67）。st2dm持续时间与FIB-4中度相关，特别是在心智年龄较大的成年人中，支持其在纤维化风险模型中的作用。

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

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.