Evidence map›Paper›PMID 40011894›Full record

ArticleBMC endocrine disorders2025

Use of noninvasive fibrosis calculators in an urban diabetes center suggests a large burden of undetected advanced liver disease.

Ahmed Ebeid, Fatma Mokhtar, Valeria Martinez-Lebron, Susie Park, Seta Degann, Jeremy Payano, Zahid Vahora, Stephen Gray, Lynt Johnson, Diala El-Maouche and 1 more

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Article in BMC endocrine disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Ahmed EbeidThe George Washington University, Washington, DC, USA.
Fatma MokhtarThe George Washington University, Washington, DC, USA.
Valeria Martinez-LebronDepartment of Medicine, The George Washington University Hospital, Washington, DC, USA.
Susie ParkDepartment of Medicine, The George Washington University Hospital, Washington, DC, USA.
Seta DegannDepartment of Medicine, The George Washington University Hospital, Washington, DC, USA.
Jeremy PayanoDepartment of Surgery, The George Washington Transplant Institute, The George Washington University Hospital, Washington, DC, USA.
Zahid VahoraDepartment of Surgery, The George Washington Transplant Institute, The George Washington University Hospital, Washington, DC, USA.
Stephen GrayDepartment of Surgery, The George Washington Transplant Institute, The George Washington University Hospital, Washington, DC, USA.
Lynt JohnsonDepartment of Surgery, The George Washington Transplant Institute, The George Washington University Hospital, Washington, DC, USA.
Diala El-MaoucheDepartment of Endocrinology, The George Washington University Medical Faculty Associates, Washington, DC, USA.
Ameer AbutalebDepartment of Surgery, The George Washington Transplant Institute, The George Washington University Hospital, Washington, DC, USA. aabutaleb@mfa.gwu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetabolic dysfunction associated steatotic liver disease (MASLD) is prevalent in up to 60% of patients with type 2 diabetes mellitus (T2DM). T2DM accelerates the risk of hepatic fibrosis and hepatocellular carcinoma in patients with MASLD. Our goal in this study was to identify patients with suspected MASLD and hepatic fibrosis in a large T2DM clinic by using noninvasive fibrosis scoring systems.

methodsWe conducted a retrospective study of patients with T2DM seen by our endocrinologists at the Medical Faculty Associates (MFA) Diabetes Center in Washington, DC, from November 1, 2021, until November 1, 2022. We included all subjects who were over 18 years old with a hemoglobin A1c (HbA1c) of 6.5 or higher. Patients with a history of significant alcohol consumption, decompensated cirrhosis, previous bariatric surgery, or prior chronic liver disease were excluded from the study. We identified patients at risk for hepatic fibrosis by using the Fibrosis-4 (FIB-4) Index, NAFLD Fibrosis Score (NFS) and AST to Platelet Ratio Index (APRI) when lab values were available.

resultsA total of 1,411 patients were evaluated for T2DM by an endocrinology provider during the one-year period. Out of these, 336 patients met one or more of the exclusion criteria, leaving a total of 1075 patients included in the analysis. The majority were African American (n = 582, 54%), 261 were Caucasian (24.3%), and 85 were Hispanic (7.9%). Most patients were females (n = 675, 62.7%). The mean HbA1c was 8.1 ± 2.3. 643 patients (59.8%) were insulin dependent. Based on FIB-4 scores, we found that 35 (3.9%) patients had a score of > 2.67 associated with advanced fibrosis and 257 (29%) patients with scores of 1.3-2.67 had moderate fibrosis. Using the NFS calculator, there were 281 (28%) patients with values of > 0.675 consistent with F3-F4 disease. 715 (71.8%) patients with values of < 0.675 consistent with F0-F2 fibrosis. A total of 6(< 1%) patients met criteria for advanced fibrosis by APRI scoring.

conclusionIn our urban Diabetes Center, utilizing the NFS calculator may detect many patients with advanced liver disease. Further research is needed to ensure the internal validity of the non-invasive tests in predicting liver fibrosis and to correlate these findings with transient elastography and other imaging evidence of fatty liver disease. CLINICAL TRIAL NUMBER: Non-applicable.

Indexed as

BiomarkersDiabetes Mellitus, Type 2Fatty LiverLiver CirrhosisAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedNon-alcoholic Fatty Liver DiseasePrognosisRetrospective StudiesBiomarkersAdvanced liver fibrosisFibrosis scoring systemsMASHMetabolic dysfunction associated steatotic liver disease (MASLD)Non-invasive tests

Identifiers

PMID40011894
PMCPMC11866707

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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.