ArticleFrontiers in gastroenterology (Lausanne, Switzerland)2026
Higher fibrosis-4 index is associated with 2-year cardiovascular events in Vietnamese adults with type 2 diabetes mellitus: a prospective cohort study.
Article in Frontiers in gastroenterology (Lausanne, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Cardiovascular disease is a major extrahepatic outcome in type 2 diabetes mellitus (T2DM) and metabolic fatty liver disease, but prospective data integrating transient elastography and the fibrosis-4 index (FIB-4) with observed cardiovascular events remain limited in Southeast Asia. Methods: We conducted a prospective cohort study of adults with T2DM consecutively recruited at a Vietnamese tertiary hospital from June 2023 through January 2025 and followed for up to 24 months. Hepatic steatosis and liver stiffness were assessed by FibroScan Results: Of 452 patients screened, 301 consented and 284 entered the baseline cohort; 280 contributed follow-up. At baseline, MAFLD was present in 72.5% and significant liver fibrosis (liver stiffness measurement ≥7.0 kPa) in 23.9%. During 544.92 person-years, 11 expanded MACE and 5 conventional MACE occurred, corresponding to incidence rates of 20.19 (95% CI 10.08-36.12) and 9.18 (95% CI 2.98-21.41) per 1,000 person-years. In the main Firth model adjusted for age and MAFLD, each increase of 1 interquartile range (IQR; 0.696 units) in FIB-4 was associated with expanded MACE (adjusted hazard ratio 1.56, 95% CI 1.09-1.99; p = 0.022), whereas MAFLD was not statistically significant (adjusted hazard ratio 3.51, 95% CI 0.79-33.09; p = 0.105); the point estimate was above unity but imprecise because of the limited number of events. Conclusion: Higher FIB-4 was associated with short-term cardiovascular events in adults with T2DM. Given the small number of events, these findings require confirmation in larger multicenter cohorts.
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