2型糖尿病患者晚期肝纤维化相关因素：墨西哥城的一项多中心研究

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Clinical and Experimental Hepatology Pub Date : 2025-02-27 DOI:10.1016/j.jceh.2025.102536

Froylan D. Martínez-Sánchez , Maria J. Corredor-Nassar , Sandra M. Feria-Agudelo , Victor M. Paz-Zarza , Carolina Martinez-Perez , Alejandra Diaz-Jarquin , Fátima Manzo-Santana , Victor A. Sánchez-Gómez , Alondra Rosales-Padron , Mónica Baca-García , Jessica Mejía-Ramírez , Ignacio García-Juárez , Fatima Higuera-de la Tijera , Jose L. Pérez-Hernandez , Beatriz Barranco-Fragoso , Nahum Méndez-Sánchez , Jacqueline Córdova-Gallardo

{"title":"2型糖尿病患者晚期肝纤维化相关因素：墨西哥城的一项多中心研究","authors":"Froylan D. Martínez-Sánchez , Maria J. Corredor-Nassar , Sandra M. Feria-Agudelo , Victor M. Paz-Zarza , Carolina Martinez-Perez , Alejandra Diaz-Jarquin , Fátima Manzo-Santana , Victor A. Sánchez-Gómez , Alondra Rosales-Padron , Mónica Baca-García , Jessica Mejía-Ramírez , Ignacio García-Juárez , Fatima Higuera-de la Tijera , Jose L. Pérez-Hernandez , Beatriz Barranco-Fragoso , Nahum Méndez-Sánchez , Jacqueline Córdova-Gallardo","doi":"10.1016/j.jceh.2025.102536","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objectives</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease, primarily due to insulin resistance and type 2 diabetes (T2D). Despite the strong link between T2D and MASLD, identifying and treating liver fibrosis in T2D patients is still poor. This study aimed to identify the factors related to advanced liver fibrosis in T2D patients.</div></div><div><h3>Methods</h3><div>This retrospective observational study used medical records from four centers in Mexico City from 2018 to 2023. The study included 2000 patients with T2D. Liver fibrosis was evaluated using the Fibrosis-4 (FIB-4) index, and insulin resistance was assessed using the estimated glucose disposal rate (eGDR).</div></div><div><h3>Results</h3><div>The mean age of the patients was 58.9 years, with 63.7% being women. The median duration of T2D was 7 years, and the mean HbA1c was 7.63%. Overall, 20.4% had advanced liver fibrosis. The multivariate logistic regression analysis showed that diabetes duration >10 years {odds ratio (OR) = 2.105 (95% confidence interval [CI] 1.321–3.355)}, fasting glucose >126 mg/dL (OR = 1.568 [95% CI 1.085–2.265]), and microalbuminuria >300 mg/24 h (OR = 2.007 [95% CI 1.134–3.552]) were associated with advanced liver fibrosis. Conversely, the eGDR (OR = 0.805 [95% CI 0.703–0.888]), statins (OR = 0.111 [95% CI 0.073–0.168]), and pioglitazone (OR = 0.082 [95% CI 0.010–0.672]) were inversely associated.</div></div><div><h3>Conclusion</h3><div>Longer diabetes duration, insulin resistance, and microalbuminuria are independently linked to advanced liver fibrosis in T2D patients. Statins and pioglitazone may protect against liver fibrosis. Enhanced screening and management strategies targeting these factors could slow fibrosis progression and reduce the global burden of MASLD.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 4","pages":"Article 102536"},"PeriodicalIF":3.3000,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Associated With Advanced Liver Fibrosis in a Population With Type 2 Diabetes: A Multicentric Study in Mexico City\",\"authors\":\"Froylan D. Martínez-Sánchez , Maria J. Corredor-Nassar , Sandra M. Feria-Agudelo , Victor M. Paz-Zarza , Carolina Martinez-Perez , Alejandra Diaz-Jarquin , Fátima Manzo-Santana , Victor A. Sánchez-Gómez , Alondra Rosales-Padron , Mónica Baca-García , Jessica Mejía-Ramírez , Ignacio García-Juárez , Fatima Higuera-de la Tijera , Jose L. Pérez-Hernandez , Beatriz Barranco-Fragoso , Nahum Méndez-Sánchez , Jacqueline Córdova-Gallardo\",\"doi\":\"10.1016/j.jceh.2025.102536\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and objectives</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease, primarily due to insulin resistance and type 2 diabetes (T2D). Despite the strong link between T2D and MASLD, identifying and treating liver fibrosis in T2D patients is still poor. This study aimed to identify the factors related to advanced liver fibrosis in T2D patients.</div></div><div><h3>Methods</h3><div>This retrospective observational study used medical records from four centers in Mexico City from 2018 to 2023. The study included 2000 patients with T2D. Liver fibrosis was evaluated using the Fibrosis-4 (FIB-4) index, and insulin resistance was assessed using the estimated glucose disposal rate (eGDR).</div></div><div><h3>Results</h3><div>The mean age of the patients was 58.9 years, with 63.7% being women. The median duration of T2D was 7 years, and the mean HbA1c was 7.63%. Overall, 20.4% had advanced liver fibrosis. The multivariate logistic regression analysis showed that diabetes duration >10 years {odds ratio (OR) = 2.105 (95% confidence interval [CI] 1.321–3.355)}, fasting glucose >126 mg/dL (OR = 1.568 [95% CI 1.085–2.265]), and microalbuminuria >300 mg/24 h (OR = 2.007 [95% CI 1.134–3.552]) were associated with advanced liver fibrosis. Conversely, the eGDR (OR = 0.805 [95% CI 0.703–0.888]), statins (OR = 0.111 [95% CI 0.073–0.168]), and pioglitazone (OR = 0.082 [95% CI 0.010–0.672]) were inversely associated.</div></div><div><h3>Conclusion</h3><div>Longer diabetes duration, insulin resistance, and microalbuminuria are independently linked to advanced liver fibrosis in T2D patients. Statins and pioglitazone may protect against liver fibrosis. Enhanced screening and management strategies targeting these factors could slow fibrosis progression and reduce the global burden of MASLD.</div></div>\",\"PeriodicalId\":15479,\"journal\":{\"name\":\"Journal of Clinical and Experimental Hepatology\",\"volume\":\"15 4\",\"pages\":\"Article 102536\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-02-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical and Experimental Hepatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0973688325000362\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical and Experimental Hepatology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0973688325000362","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景和目的代谢功能障碍相关脂肪变性肝病（MASLD）是慢性肝病的主要原因，主要由胰岛素抵抗和2型糖尿病（T2D）引起。尽管T2D和MASLD之间有很强的联系，但T2D患者肝纤维化的识别和治疗仍然很差。本研究旨在确定与T2D患者晚期肝纤维化相关的因素。方法本回顾性观察性研究使用了墨西哥城四个中心2018年至2023年的医疗记录。该研究包括2000名T2D患者。使用纤维化-4 （FIB-4）指数评估肝纤维化，使用估计的葡萄糖处置率（eGDR）评估胰岛素抵抗。结果患者平均年龄58.9岁，女性占63.7%。T2D的中位病程为7年，平均HbA1c为7.63%。总体而言，20.4%为晚期肝纤维化。多因素logistic回归分析显示，糖尿病病程10年{比值比(OR) = 2.105(95%可信区间[CI] 1.321-3.355)}、空腹血糖>；126 mg/dL （OR = 1.568 [95% CI 1.085-2.265]）、微量蛋白尿>；300 mg/24 h （OR = 2.007 [95% CI 1.134-3.552]）与晚期肝纤维化相关。相反，eGDR （OR = 0.805 [95% CI 0.703-0.888]）、他汀类药物（OR = 0.111 [95% CI 0.073-0.168]）和吡格列酮（OR = 0.082 [95% CI 0.010-0.672]）呈负相关。结论糖尿病病程延长、胰岛素抵抗和微量白蛋白尿与T2D晚期肝纤维化独立相关。他汀类药物和吡格列酮可预防肝纤维化。针对这些因素的加强筛查和管理策略可以减缓纤维化进展并减轻MASLD的全球负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Factors Associated With Advanced Liver Fibrosis in a Population With Type 2 Diabetes: A Multicentric Study in Mexico City

查看原文本刊更多论文

Factors Associated With Advanced Liver Fibrosis in a Population With Type 2 Diabetes: A Multicentric Study in Mexico City

Background and objectives

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease, primarily due to insulin resistance and type 2 diabetes (T2D). Despite the strong link between T2D and MASLD, identifying and treating liver fibrosis in T2D patients is still poor. This study aimed to identify the factors related to advanced liver fibrosis in T2D patients.

Methods

This retrospective observational study used medical records from four centers in Mexico City from 2018 to 2023. The study included 2000 patients with T2D. Liver fibrosis was evaluated using the Fibrosis-4 (FIB-4) index, and insulin resistance was assessed using the estimated glucose disposal rate (eGDR).

Results

The mean age of the patients was 58.9 years, with 63.7% being women. The median duration of T2D was 7 years, and the mean HbA1c was 7.63%. Overall, 20.4% had advanced liver fibrosis. The multivariate logistic regression analysis showed that diabetes duration >10 years {odds ratio (OR) = 2.105 (95% confidence interval [CI] 1.321–3.355)}, fasting glucose >126 mg/dL (OR = 1.568 [95% CI 1.085–2.265]), and microalbuminuria >300 mg/24 h (OR = 2.007 [95% CI 1.134–3.552]) were associated with advanced liver fibrosis. Conversely, the eGDR (OR = 0.805 [95% CI 0.703–0.888]), statins (OR = 0.111 [95% CI 0.073–0.168]), and pioglitazone (OR = 0.082 [95% CI 0.010–0.672]) were inversely associated.

Conclusion

Longer diabetes duration, insulin resistance, and microalbuminuria are independently linked to advanced liver fibrosis in T2D patients. Statins and pioglitazone may protect against liver fibrosis. Enhanced screening and management strategies targeting these factors could slow fibrosis progression and reduce the global burden of MASLD.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊