Endocrinol Metab.  2023 Apr;38(2):277-281. 10.3803/EnM.2022.1635.

Performance of Simple Fibrosis Score in Non-Alcoholic Fatty Liver Disease with and without Type 2 Diabetes

• Chung SM
• Kang MK
• Moon JS
• Park JG

• KMID: 2541884
• DOI: http://doi.org/10.3803/EnM.2022.1635

Abstract

This cross-sectional study enrolled 267 patients with metabolic risk factors and established non-alcoholic fatty liver disease in the prospective cohort. The performance of fibrosis-4 (FIB-4) score (≥1.3) to diagnose advanced fibrosis using transient elastography (liver stiffness measurement [LSM] ≥8 kPa) was analyzed. Comparing patients with type 2 diabetes (T2D, n=87) and without (n=180), not FIB-4, but LSM was significantly higher in T2D (P=0.026). The prevalence of advanced fibrosis was 17.2% in T2D and 12.8% in non-T2D. FIB-4 exhibited higher proportion of false negatives in T2D patients (10.9%) than those without (5.2%). The diagnostic performance of FIB-4 was suboptimal in T2D (area under curve [AUC], 0.653; 95% confidence interval [CI], 0.462 to 0.844) compared to that in non-T2D (AUC, 0.826; 95% CI, 0.724 to 0.927). In conclusion, patients with T2D might be beneficial to conduct transient elastography without screening to avoid missing advanced fibrosis.

Keyword

Diabetes mellitus; Non-alcoholic fatty liver disease; Liver cirrhosis; Diagnostic screening programs

Figure

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  Fig. 1. (A, B) Fibrosis-4 (FIB-4) score and transient elastography profiles. Box with annotation indicates mean. Bar indicates standard deviation. (C, D) FIB-4 performance for advanced fibrosis (liver stiffness measurement [LSM] ≥8 kPa) according to the diabetes status. Receiver operating characteristic curve analysis was performed. T2D, type 2 diabetes; AUC, area under curve; CI, confidence interval. aP<0.05.

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