ArticleHepatology international2024
The impact of an increased Fibrosis-4 index and the severity of hepatic steatosis on mortality in individuals living with diabetes.
Article in Hepatology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Serum 25(OH)D3 and advanced liver fibrosis in type 2 diabetes: a Chinese hospital cohort with NHANES validation and mortality follow-up.Frontiers in nutrition · 2026Article
- Assessing the association of FIB-4 index with diabetic kidney disease in patients with diabetes mellitus: a cross-sectional and retrospective study utilizing NHANES and clinical data.Frontiers in endocrinology · 2026Article
- Unveiling the prognostic power of FIB-4 index: a new frontier in heart failure mortality.European journal of medical research · 2025Article
- Cardiovascular-kidney-metabolic (CKM) syndrome is associated with increased mortality in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD).Communications medicine · 2025Article
- Association of serum lactate dehydrogenase levels with non-alcoholic fatty liver disease and advanced hepatic fibrosis in the United States: a cross-sectional study using NHANES data from 2007 to 2018.BMC gastroenterology · 2025Article
- Relationships among fibrosis-4, triglyceride-glucose index, and cardiovascular disease: Evidence from the NHANES 2003-2018.American journal of preventive cardiology · 2025Article
- [Exploring the relationship between alcohol intake and all-cause mortality in participants with MASLD and MetALD: a study based on NHANES III data].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Article
- Liver fibrosis assessed via noninvasive liver fibrosis scores is associated with atherosclerotic cardiovascular disease in middle-aged and older patients with prediabetes.Frontiers in endocrinology · 2025Article
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14 authors.
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Abstract
BACKGROUND AND
aimsData on the effects of liver fibrosis and hepatic steatosis on outcomes in individuals living with diabetes are limited. Therefore, we investigated the predictive value of the fibrosis and the severity of hepatic steatosis for all-cause mortality in individuals living with diabetes.
methodsA total of 1903 patients with diabetes from the Third National Health and Nutrition Examination Survey (NHANES III) dataset were enrolled. Presumed hepatic fibrosis was evaluated with Fibrosis-4 index (FIB-4). The mortality risk and corresponding hazard ratio (HR) were analyzed with the Kaplan-Meier method and multivariable Cox proportional hazard models.
resultsOver a median follow-up of 19.4 years, all-cause deaths occurred in 69.6%. FIB-4 ≥ 1.3 was an independent predictor of mortality in individuals living with diabetes (HR 1.219, 95% confidence interval [CI]: 1.067-1.392, p = 0.004). Overall, FIB-4 ≥ 1.3 without moderate-severe steatosis increased the mortality risk (HR 1.365; 95%CI 1.147-1.623, p < 0.001). The similar results were found in individuals living with diabetes with metabolic dysfunction-associated fatty liver disease (MAFLD) (HR 1.499; 95%CI 1.065-2.110, p = 0.020), metabolic syndrome (MetS) (HR 1.397; 95%CI 1.086-1.796, p = 0.009) or abdominal obesity (HR 1.370; 95%CI 1.077-1.742, p = 0.010).
conclusionsLiver fibrosis, as estimated by FIB-4, may serve as a more reliable prognostic indicator for individuals living with diabetes than hepatic steatosis. Individuals living with diabetes with FIB-4 ≥ 1.3 without moderate-severe steatosis had a significantly increased all-cause mortality risk. These findings highlight the importance of identifying and monitoring those individuals, as they may benefit from further evaluation and risk stratification.
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