ArticleDiabetes care2021
Advanced Liver Fibrosis Is Common in Patients With Type 2 Diabetes Followed in the Outpatient Setting: The Need for Systematic Screening.
Article in Diabetes care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06694974 (A Randomized Controlled Trial for Liver Fibrosis Assessment in Diabetic Patients), which is not on this map. Cited by 182 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Controlled Trial for Liver Fibrosis Assessment in Diabetic Patients
Who cites it
182 citing papers in PubMed, 3 syntheses or guidelines pooled it, 331 citations in OpenAlex.
- Liver-related aspects of valoctocogene roxaparvovec gene therapy for hemophilia A: expert guidance for clinical practice.Blood advances · 2024Guideline
- Type 2 diabetes, hepatic decompensation, and hepatocellular carcinoma in patients with non-alcoholic fatty liver disease: an individual participant-level data meta-analysis.The lancet. Gastroenterology & hepatology · 2023Pooled it
- Clinical Care Pathway for the Risk Stratification and Management of Patients With Nonalcoholic Fatty Liver Disease.Gastroenterology · 2021Guideline
- Effects of Dapagliflozin on Cardiovascular Outcomes in Patients With Type 2 Diabetes at Risk of Liver Fibrosis.Diabetes, obesity & metabolism · 2026Trial
- Similar weight loss with semaglutide regardless of diabetes and cardiometabolic risk parameters in individuals with metabolic dysfunction-associated steatotic liver disease: Post hoc analysis of three randomised controlled trials.Diabetes, obesity & metabolism · 2025Trial
- Trial
- Association between hepatic steatosis and fibrosis with measures of insulin sensitivity in patients with severe obesity and type 2 diabetes - a cross-sectional study.BMC gastroenterology · 2022Trial
- Screening and diagnosis of liver disease in diabetes: a guide and evidence-based assessment.Diabetologia · 2026Review
- Identifying MASLD Patients with MASH or Significant Fibrosis: The Role of Lower ALT Thresholds.Journal of clinical medicine · 2026Article
- MASLD in type 2 diabetes: steatosis-fibrosis burden and metabolic determinants in a real-world cohort.Acta diabetologica · 2026Article
- MMP-9 and non-invasive markers in evaluating MASLD and atherosclerosis.Journal, genetic engineering & biotechnology · 2026Article
- Assessment of Liver Stiffness in a Rat Model of Type 2 Diabetes Using Shear Wave Elastography.Diagnostics (Basel, Switzerland) · 2026Article
- High Prevalence of Metabolic Dysfunction-Associated Steatohepatitis With Significant Fibrosis in Primary Care and Endocrinology Clinics.Diabetes, obesity & metabolism · 2026Article
- Associations of the insulinemic potential of diet and lifestyle with metabolic dysfunction-associated steatotic liver disease (MASLD) risk in adults with type 2 diabetes.Scientific reports · 2026Article
- Severity of MASH activity by iron-corrected MRI predicts insulin resistance and cardiometabolic risk in type 2 diabetes.The Journal of clinical endocrinology and metabolism · 2026Article
- Reduced circulating Mig-6 levels are associated with dysglycemia in metabolic dysfunction associated steatotic liver disease (MASLD).BMJ open diabetes research & care · 2026Article
- Breast Cancer and Metabolic Dysfunction-Associated Steatotic Liver Disease.International journal of molecular sciences · 2026Review
- Dual Modulation of Senescence and Immune Checkpoints by Metformin and Dapagliflozin Attenuates Liver Fibrosis in a Thioacetamide-Induced Rat Model.Advanced pharmaceutical bulletin · 2026Article
- Toll of Chronic Metabolic Acidosis at Molecular, Cellular, and Systemic Levels: A Conceptual Framework to Revisit Type 2 Diabetes (T2D) Pathophysiology.Biomedicines · 2026Review
- The global cardiovascular-liver-metabolic syndemic: epidemiology, trends and challenges.Nature reviews. Cardiology · 2026Review
122 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAssess the prevalence of nonalcoholic fatty liver disease (NAFLD) and of liver fibrosis associated with nonalcoholic steatohepatitis in unselected patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND
methodsA total of 561 patients with T2DM (age: 60 ± 11 years; BMI: 33.4 ± 6.2 kg/m
resultsThe prevalence of steatosis was 70% and of fibrosis 21% (LSM ≥7.0 kPa). Moderate fibrosis (F2: LSM ≥8.2 kPa) was present in 6% and severe fibrosis or cirrhosis (F3-4: LSM ≥9.7 kPa) in 9%, similar to that estimated by FIB-4 and APRI panels. Noninvasive testing was consistent with liver biopsy results. Elevated AST or ALT ≥40 units/L was present in a minority of patients with steatosis (8% and 13%, respectively) or with liver fibrosis (18% and 28%, respectively). This suggests that AST/ALT alone are insufficient as initial screening. However, performance may be enhanced by imaging (e.g., transient elastography) and plasma diagnostic panels (e.g., FIB-4 and APRI).
conclusionsModerate-to-advanced fibrosis (F2 or higher), an established risk factor for cirrhosis and overall mortality, affects at least one out of six (15%) patients with T2DM. These results support the American Diabetes Association guidelines to screen for clinically significant fibrosis in patients with T2DM with steatosis or elevated ALT.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.