ArticleDiabetes care2022
Noninvasive Fibrosis Screening in Fatty Liver Disease Among Vulnerable Populations: Impact of Diabetes and Obesity on FIB-4 Score Accuracy.
Article in Diabetes care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Prognostic value of FIB-4 and NFS for cardiovascular events in patients with and without NAFLD.BMC public health · 2025Pooled it
- Assessing the effects of naltrexone-bupropion on hepatic steatosis and fibrosis in patients with T2DM and overweight or obesity: Insights from a placebo-controlled trial.Diabetes, obesity & metabolism · 2025Trial
- Review Article: Fibrosis Reversal in Metabolic Dysfunction-Associated Steatohepatitis-The Promise of Emerging Therapeutics.Alimentary pharmacology & therapeutics · 2026Review
- Early identification of cirrhosis risk in type 2 diabetes using the Fibrosis-4 index: evidence from a large U.S. cohort.BMC endocrine disorders · 2026Article
- Care Pathways for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-The-Art Review.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Diabetes and obesity reduce FIB-4 accuracy in MASLD referral pathways.JHEP reports : innovation in hepatology · 2026Article
- FibroX: a machine learning model for detecting and prognosticating advanced fibrosis in metabolic dysfunction-associated steatotic liver disease.Translational gastroenterology and hepatology · 2026Article
- Clinical utility of the MAF-5 score for assessing MAFLD/MASLD in a Japanese population with obesity.Diabetology international · 2026Article
- Use of FibroScan-AST (FAST) Score and Fibrosis-4 Index to Identify Advanced Liver Fibrosis in Patients with Type 2 Diabetes and Metabolic Dysfunction-Associated Steatotic Liver Disease.Journal of clinical medicine · 2025Article
- The Need for Population-Specific Validation in MASLD Screening.Diabetes care · 2025Article
- Screening of advanced fibrosis and metabolic dysfunction-associated steatotic liver disease using transient elastography in vulnerable population.Scientific reports · 2025Article
- Comparing FIB-4, VCTE, pSWE, 2D-SWE, and MRE Thresholds and Diagnostic Accuracies for Detecting Hepatic Fibrosis in Patients with MASLD: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2025Review
- Relationships among fibrosis-4, triglyceride-glucose index, and cardiovascular disease: Evidence from the NHANES 2003-2018.American journal of preventive cardiology · 2025Article
- Effect of imeglimin on metabolic dysfunction-associated steatotic liver disease in individuals with type 2 diabetes.PloS one · 2025Observational
- DoesHepatology forum · 2025Article
- Estimating the prevalence of adults at risk for advanced hepatic fibrosis using FIB-4 in a Swiss tertiary care hospital.PloS one · 2025Article
- Modified FIB-4 Index in Type 2 Diabetes Mellitus with Steatosis: A Non-Linear Predictive Model for Advanced Hepatic Fibrosis.Diagnostics (Basel, Switzerland) · 2024Article
- Using Phosphatidylethanol as an Adjunct to Self-Reported Alcohol Use Improves Identification of Liver Fibrosis Risk.The American journal of gastroenterology · 2024Article
- Diagnostic performance of new BAST score versus FIB-4 index in predicating of the liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease.European journal of medical research · 2024Article
- One-step non-invasive diagnosis of metabolic dysfunction-associated steatohepatitis and fibrosis in high-risk population.United European gastroenterology journal · 2024Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveFatty liver disease (FLD) is prevalent in diabetes, and both disproportionately affect vulnerable populations. The FIB-4 index is recommended to screen for advanced liver fibrosis. Limited data have suggested that diabetes may impact FIB-4. RESEARCH DESIGN AND
methodsWe evaluated FIB-4 accuracy for advanced fibrosis compared with liver biopsy in the presence of diabetes and obesity.
resultsAmong 363 FLD patients receiving care in San Francisco's safety net health care system from August 2009 to February 2020, characteristics were as follows: median age 51 years, 46% male, 59% Hispanic, 68% obese, 33% with diabetes, and 31% with advanced fibrosis on histology. Overall, the c-statistic for FIB-4 was 0.79, but was worse in patients with diabetes, 0.68, than without, 0.85 (P = 0.003). Accuracy also varied by weight, at 0.65, 0.85, and 0.75 for normal weight, overweight, and obese, respectively, although not significantly (P = 0.24).
conclusionsThe findings highlight limitations of FIB-4 in screening for advanced liver fibrosis, particularly in individuals with diabetes.
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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.