ArticleBMC endocrine disorders2026
Early identification of cirrhosis risk in type 2 diabetes using the Fibrosis-4 index: evidence from a large U.S. cohort.
Article in BMC endocrine disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsCirrhosis remains a leading cause of liver-related morbidity and mortality and is often diagnosed only at advanced stages. Individuals with type 2 diabetes mellitus (T2DM) are at increased risk, yet systematic screening for early fibrosis is rarely implemented. We evaluated whether the Fibrosis-4 (FIB-4) index, a widely used non-invasive biomarker, can identify elevated cirrhosis risk near the time of T2DM diagnosis.
methodsWe conducted a retrospective cohort study using the NIH All of Us Research Program database. Adults with newly diagnosed T2DM and laboratory data for FIB-4 calculation within ± 365 days of diagnosis were included. Cases were participants who subsequently developed cirrhosis; controls were those who did not. FIB-4 distributions were compared using Wilcoxon rank-sum tests. Cox proportional hazards models assessed the association between FIB-4 and time to cirrhosis. Discriminative ability was evaluated using receiver operating characteristic (ROC) analysis, and Kaplan-Meier curves compared time-to-event outcomes by FIB-4 category.
resultsAmong 9,253 participants (136 cases, 9,117 controls), median FIB-4 was higher in cases (1.38; 95% CI: 1.25-1.48) than controls (1.00; 95% CI: 0.99-1.01; p < 0.001). Higher FIB-4 was associated with increased cirrhosis risk in Cox regression analyses (adjusted HR = 1.16 per 1‑unit increase; 95% CI 1.08-1.24; p < 0.001). ROC analysis yielded an AUROC of 0.66, indicating moderate discriminative ability, with an optimal cutoff of 1.23 derived for internal stratification. Kaplan-Meier analysis showed shorter time to cirrhosis for FIB-4 ≥ 1.23 (log-rank p < 0.001).
conclusionsFIB-4 measured near T2DM diagnosis may serve as an early signal for cirrhosis risk. Incorporating FIB-4 into diabetes care pathways could enable timely referral and intervention, improving long-term liver outcomes. CLINICAL TRIAL NUMBER: Not applicable.
Indexed as
Identifiers
What OpenQuestion holds
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.