Xiao-Dong Zhou, Qin-Fen Chen, Seung Up Kim, Terry Cheuk-Fung Yip, Salvatore Petta, Atsushi Nakajima, Emmanuel Tsochatzis, Jérôme Boursier, Elisabetta Bugianesi, Hannes Hagström, Wah-Kheong Chan, Manuel Romero-Gomez, José Luis Calleja, Victor de Lédinghen, Laurent Castéra, Arun J Sanyal, Boon-Bee George Goh, Philip Noel Newsome, Jian-Gao Fan, Michelle Lai, Céline Fournier-Poizat, Hye Won Lee, Grace Lai-Hung Wong, Angelo Armandi, Ying Shang, Grazia Pennisi, Elba Llop, Masato Yoneda, Mirko Zoncapè, Marc de Saint-Loup, Clemence M Canivet, Carmen Lara-Romero, Rocio Gallego-Durán, Paloma Carrillo-Fernández, Amon Asgharpour, Kevin Kim-Jun Teh, Mandy Sau-Wai Chan, Huapeng Lin, Wen-Yue Liu, Giovanni Targher, Christopher D Byrne, Vincent Wai-Sun Wong, Ming-Hua Zheng
{"title":"MASLD患者长期血糖控制与肝脏僵硬进展及肝脏相关事件的风险","authors":"Xiao-Dong Zhou, Qin-Fen Chen, Seung Up Kim, Terry Cheuk-Fung Yip, Salvatore Petta, Atsushi Nakajima, Emmanuel Tsochatzis, Jérôme Boursier, Elisabetta Bugianesi, Hannes Hagström, Wah-Kheong Chan, Manuel Romero-Gomez, José Luis Calleja, Victor de Lédinghen, Laurent Castéra, Arun J Sanyal, Boon-Bee George Goh, Philip Noel Newsome, Jian-Gao Fan, Michelle Lai, Céline Fournier-Poizat, Hye Won Lee, Grace Lai-Hung Wong, Angelo Armandi, Ying Shang, Grazia Pennisi, Elba Llop, Masato Yoneda, Mirko Zoncapè, Marc de Saint-Loup, Clemence M Canivet, Carmen Lara-Romero, Rocio Gallego-Durán, Paloma Carrillo-Fernández, Amon Asgharpour, Kevin Kim-Jun Teh, Mandy Sau-Wai Chan, Huapeng Lin, Wen-Yue Liu, Giovanni Targher, Christopher D Byrne, Vincent Wai-Sun Wong, Ming-Hua Zheng","doi":"10.1016/j.cgh.2025.10.003","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The long-term impact of type 2 diabetes (T2D) status and long-term glycemic control on disease progression and clinical outcomes in metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear.</p><p><strong>Aims: </strong>To assess the association of diabetes status and long-term glycemic control with liver stiffness progression or regression, and liver-related events (LRE) in MASLD.</p><p><strong>Methods: </strong>We analyzed patients with MASLD from the VCTE-Prognosis cohort who underwent serial vibration-controlled transient elastography (VCTE) assessments and HbA1c measurements. Long-term glycemic control was evaluated using the time-weighted average (TWA) HbA1c, which reflects both the magnitude and duration of glycemia. Patients were categorized as non-T2D, well-controlled T2D (TWA HbA1c<7%), or poorly controlled T2D (TWA HbA1c≥7%). Liver stiffness progression, regression, and LRE were examined using Kaplan-Meier analyses and Cox proportional hazards models.</p><p><strong>Results: </strong>Of 7,543 patients with MASLD, 4,090 had T2D (2,045 well-controlled, 2,045 poorly controlled), and 3,453 did not have T2D. Over a median follow-up of 4.1 years, patients with T2D had a higher risk of liver stiffness progression (HR=1.501, 95%CI 1.148-1.962, P=0.003) and LRE (HR=2.030, 95%CI 1.241-3.320, P=0.005), but not liver stiffness regression, compared to non-T2D patients. Among patients with T2D, poor glycemic control was associated with a higher risk of liver stiffness progression compared with good glycemic control (HR=1.524, 95%CI 1.182-1.965, P=0.001). No differences were observed for liver stiffness regression (P=0.957) or LRE (P=0.625) with glycemic control. Findings were consistent across sensitivity analyses.</p><p><strong>Conclusions: </strong>T2D was independently associated with a higher risk of liver stiffness progression and LRE in MASLD. Good glycemic control was associated with slower liver stiffness progression, but not regression or LRE.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0000,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-Term Glycemic Control and the Risk of Liver Stiffness Progression and Liver-Related Events in MASLD.\",\"authors\":\"Xiao-Dong Zhou, Qin-Fen Chen, Seung Up Kim, Terry Cheuk-Fung Yip, Salvatore Petta, Atsushi Nakajima, Emmanuel Tsochatzis, Jérôme Boursier, Elisabetta Bugianesi, Hannes Hagström, Wah-Kheong Chan, Manuel Romero-Gomez, José Luis Calleja, Victor de Lédinghen, Laurent Castéra, Arun J Sanyal, Boon-Bee George Goh, Philip Noel Newsome, Jian-Gao Fan, Michelle Lai, Céline Fournier-Poizat, Hye Won Lee, Grace Lai-Hung Wong, Angelo Armandi, Ying Shang, Grazia Pennisi, Elba Llop, Masato Yoneda, Mirko Zoncapè, Marc de Saint-Loup, Clemence M Canivet, Carmen Lara-Romero, Rocio Gallego-Durán, Paloma Carrillo-Fernández, Amon Asgharpour, Kevin Kim-Jun Teh, Mandy Sau-Wai Chan, Huapeng Lin, Wen-Yue Liu, Giovanni Targher, Christopher D Byrne, Vincent Wai-Sun Wong, Ming-Hua Zheng\",\"doi\":\"10.1016/j.cgh.2025.10.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The long-term impact of type 2 diabetes (T2D) status and long-term glycemic control on disease progression and clinical outcomes in metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear.</p><p><strong>Aims: </strong>To assess the association of diabetes status and long-term glycemic control with liver stiffness progression or regression, and liver-related events (LRE) in MASLD.</p><p><strong>Methods: </strong>We analyzed patients with MASLD from the VCTE-Prognosis cohort who underwent serial vibration-controlled transient elastography (VCTE) assessments and HbA1c measurements. Long-term glycemic control was evaluated using the time-weighted average (TWA) HbA1c, which reflects both the magnitude and duration of glycemia. Patients were categorized as non-T2D, well-controlled T2D (TWA HbA1c<7%), or poorly controlled T2D (TWA HbA1c≥7%). Liver stiffness progression, regression, and LRE were examined using Kaplan-Meier analyses and Cox proportional hazards models.</p><p><strong>Results: </strong>Of 7,543 patients with MASLD, 4,090 had T2D (2,045 well-controlled, 2,045 poorly controlled), and 3,453 did not have T2D. Over a median follow-up of 4.1 years, patients with T2D had a higher risk of liver stiffness progression (HR=1.501, 95%CI 1.148-1.962, P=0.003) and LRE (HR=2.030, 95%CI 1.241-3.320, P=0.005), but not liver stiffness regression, compared to non-T2D patients. Among patients with T2D, poor glycemic control was associated with a higher risk of liver stiffness progression compared with good glycemic control (HR=1.524, 95%CI 1.182-1.965, P=0.001). No differences were observed for liver stiffness regression (P=0.957) or LRE (P=0.625) with glycemic control. Findings were consistent across sensitivity analyses.</p><p><strong>Conclusions: </strong>T2D was independently associated with a higher risk of liver stiffness progression and LRE in MASLD. Good glycemic control was associated with slower liver stiffness progression, but not regression or LRE.</p>\",\"PeriodicalId\":10347,\"journal\":{\"name\":\"Clinical Gastroenterology and Hepatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":12.0000,\"publicationDate\":\"2025-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Gastroenterology and Hepatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.cgh.2025.10.003\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Gastroenterology and Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cgh.2025.10.003","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Long-Term Glycemic Control and the Risk of Liver Stiffness Progression and Liver-Related Events in MASLD.
Background: The long-term impact of type 2 diabetes (T2D) status and long-term glycemic control on disease progression and clinical outcomes in metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear.
Aims: To assess the association of diabetes status and long-term glycemic control with liver stiffness progression or regression, and liver-related events (LRE) in MASLD.
Methods: We analyzed patients with MASLD from the VCTE-Prognosis cohort who underwent serial vibration-controlled transient elastography (VCTE) assessments and HbA1c measurements. Long-term glycemic control was evaluated using the time-weighted average (TWA) HbA1c, which reflects both the magnitude and duration of glycemia. Patients were categorized as non-T2D, well-controlled T2D (TWA HbA1c<7%), or poorly controlled T2D (TWA HbA1c≥7%). Liver stiffness progression, regression, and LRE were examined using Kaplan-Meier analyses and Cox proportional hazards models.
Results: Of 7,543 patients with MASLD, 4,090 had T2D (2,045 well-controlled, 2,045 poorly controlled), and 3,453 did not have T2D. Over a median follow-up of 4.1 years, patients with T2D had a higher risk of liver stiffness progression (HR=1.501, 95%CI 1.148-1.962, P=0.003) and LRE (HR=2.030, 95%CI 1.241-3.320, P=0.005), but not liver stiffness regression, compared to non-T2D patients. Among patients with T2D, poor glycemic control was associated with a higher risk of liver stiffness progression compared with good glycemic control (HR=1.524, 95%CI 1.182-1.965, P=0.001). No differences were observed for liver stiffness regression (P=0.957) or LRE (P=0.625) with glycemic control. Findings were consistent across sensitivity analyses.
Conclusions: T2D was independently associated with a higher risk of liver stiffness progression and LRE in MASLD. Good glycemic control was associated with slower liver stiffness progression, but not regression or LRE.
期刊介绍：
Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion.
As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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