Automated Fibrosis-4 Index: Simplifying Non-Alcoholic Fatty Liver Disease for Diabetologists
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Extraction
2.3. FIB-4 Index Risk Stratification
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Factors Associated with Advanced Fibrosis According to the FIB-4 Index
3.3. Advanced Fibrosis According to the Liver Enzymes
3.4. Predictors of Advanced Fibrosis in Patients with T2D and NAFLD
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Total n = 318 | Advanced Fibrosis n = 31 | No Advanced Fibrosis n = 287 | p Value |
---|---|---|---|---|
Age, years | 54.8 ± 13.3 | 62.5 ± 10.9 | 53.9 ± 13.3 | 0.001 |
Sex (n, %) | ||||
Male | 144 (45.3) | 15 (10.4) | 129 (89.6) | |
Female | 174 (54.7) | 16 (9.2) | 158 (90.8) | |
Saudi (n, %) | 285 (89.6) | 28 (9.8) | 257 (90.2) | |
HSI (n = 313) | 42.2 ± 8.6 | 40.2 ± 9.6 | 42.4 ± 8.5 | |
No steatosis (<36) (n, %) | 50 (16.0) | 6 (12.0) | 44 (88.0) | |
Steatosis (>36) (n, %) | 263 (84.0) | 24 (9.1) | 239 (90.9) | |
BMI (kg/m2) | 32.0 ± 6.7 | 30.1 ± 4.9 | 32.2 ± 6.8 | |
Hypertension (n = 316, %) | ||||
Yes | 177 (56.0) | 20 (11.3) | 157 (88.7) | |
No | 139 (44.0) | 11 (7.9) | 128 (92.1) | |
Hemoglobin (g/dL) | 12.9 ± 2.1 | 12.8 ± 2.3 | 12.9 ± 2.0 | |
Platelets (×109/L) | 263 (218–324) | 167 (133–194) | 272 (232–335) | <0.001 |
Bilirubin (mg/dL) | 0.5 (0.3–0.7) | 0.7 (0.5–1.0) | 0.4 (0.3–0.6) | <0.001 |
Albumin (g/dL) | 4.1 (3.8–4.3) | 3.9 (3.6–4.1) | 4.1 (3.8–4.3) | 0.004 |
AST (IU/L) | 17 (14–22) | 25 (20–45) | 17 (13–21) | <0.001 |
ALT (IU/L) | 19 (13–28) | 26 (16–53) | 18 (13–27) | 0.005 |
GGT (IU/L) | 23 (16–34) | 34 (17–144) | 23 (16–33) | 0.007 |
FBS (mg/dL) | 131 (105–169) | 139 (111–195) | 130 (105–166) | |
Hemoglobin A1c (n, %) | 8.0 ± 1.9 | 7.6 ± 1.8 | 8.1 ± 1.9 | |
Total CHOL (mg/dL) | 164.3 ± 43.5 | 147.8 ± 37.8 | 166.1 ± 43.8 | 0.026 |
LDL (mg/dL) | 97 (72–129) | 73 (66–118) | 98 (75–129) | 0.015 |
HDL (mg/dL) | 43.8 ± 12.7 | 41.7 ± 13.2 | 44.0 ± 12.7 | |
TG (mg/dL) | 114 (81–159) | 107 (74–145) | 115 (85–160) | |
INR | 1.00 (0.95–1.05) | 1.06 (1.00–1.12) | 0.99 (0.95–1.04) | <0.001 |
FIB-4 | 0.8 (0.6–1.2) | 2.1 (1.6, 2.5) | 0.7 (0.5–1.1) | <0.001 |
Medications (n, %) | ||||
Insulin | 172 (54.1) | 20 (11.6) | 152 (88.4) | |
Metformin | 244 (76.7) | 21 (8.6) | 223 (91.4) | |
Sulfonylurea | 17 (5.3) | 1 (5.9) | 16 (94.1) | |
DPP-4 inhibitors (gliptins) | 112 (35.2) | 12 (10.7) | 100 (89.3) | |
SGLT2 inhibitors (gliflozins) | 140 (44.0) | 16 (11.4) | 124 (88.6) | |
GLP-1 agonist | 97 (30.6) | 9 (9.3) | 88 (90.7) | |
Pioglitazone | 6 (1.9) | 2 (33.3) | 4 (66.7) | |
Statin | 254 (79.9) | 28 (11.0) | 226 (89.0) | |
Ezetimibe | 39 (12.3) | 4 (10.3) | 35 (89.7) |
Variable | OR | 95% CI | p Value |
---|---|---|---|
Age (years) | 1.06 | 1.02–1.10 | 0.003 |
Elevated total bilirubin (>1 mg) | 4.86 | 1.55–15.19 | 0.007 |
Elevated GGT (>55 IU/mL) | 5.16 | 2.10–12.68 | <0.001 |
Prolonged INR (>1.2) | 4.18 | 1.17–14.96 | 0.028 |
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Ismail, M.H.; Al Argan, R.; Elamin, Y.; Makki, M.; Alsheekh, L.; Alelyani, J.; Hadhiah, Z.; Aljidhr, Z.; Alkhatam, N.; Alfaddagh, H.; et al. Automated Fibrosis-4 Index: Simplifying Non-Alcoholic Fatty Liver Disease for Diabetologists. Medicina 2024, 60, 1278. https://doi.org/10.3390/medicina60081278
Ismail MH, Al Argan R, Elamin Y, Makki M, Alsheekh L, Alelyani J, Hadhiah Z, Aljidhr Z, Alkhatam N, Alfaddagh H, et al. Automated Fibrosis-4 Index: Simplifying Non-Alcoholic Fatty Liver Disease for Diabetologists. Medicina. 2024; 60(8):1278. https://doi.org/10.3390/medicina60081278
Chicago/Turabian StyleIsmail, Mona H., Reem Al Argan, Yasir Elamin, Murtaga Makki, Lameya Alsheekh, Jaber Alelyani, Zahra Hadhiah, Zahrah Aljidhr, Nazih Alkhatam, Hind Alfaddagh, and et al. 2024. "Automated Fibrosis-4 Index: Simplifying Non-Alcoholic Fatty Liver Disease for Diabetologists" Medicina 60, no. 8: 1278. https://doi.org/10.3390/medicina60081278