Advanced liver fibrosis predicts heart failure and hospitalizations in people with type 2 diabetes: A prospective cohort study from Hong Kong Diabetes Register
Authors' conclusion
T2D comorbid with liver steatosis and advanced liver fibrosis are distinct clinical entities with differences in outcomes. Advanced liver fibrosis is an important predictor for worse outcomes including heart failure and hospitalizations in people with T2D.
Study context
- Population
- Patients with T2D who underwent transient elastography in 2013–2014; 56% men, mean age 60.8±11.5 years, HbA1c 7.8±1.6 %
- Participants
- 1,734 patients
- Exposure
- Advanced liver fibrosis or liver steatosis vs normal liver
- Advanced liver fibrosisn = 296
- Liver steatosisn = 798
- Normal livern = 640reference
- Outcome
- Clinical outcomes including hospitalizations and mortality
- Follow-up
- Median 6.07 (IQR 5.84 to 6.30) years
Methodological detailsHong Kong Diabetes Register
- Hong Kong Diabetes Register
Main finding
As reported in the abstract
Clinical outcomes:
- Cox regression
- Adjusted for potential confounders
Each group vs normal liverHazard ratio (95% CI)P value
Advanced liver fibrosisheart failure
3.07(1.08–8.68)
P = 0.035Advanced liver fibrosishospitalizations
1.39(1.14–1.70)
P = 0.001Liver steatosismortality
0.60(0.41–0.87)
P = 0.007- Incident hospitalizations
- 4,403
- Days of hospital stay
- 32,119
- Deaths
- 171
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Advanced liver fibrosis had higher BMI, waist circumference, WHR, FPG, HbA1c, blood pressure and lipid profiles than non-alcoholic fatty liver disease (NAFLD) or normal liver (all p < 0.05)
Original publication
Advanced liver fibrosis predicts heart failure and hospitalizations in people with type 2 diabetes: A prospective cohort study from Hong Kong Diabetes Register. Diabetes Res Clin Pract. Published 11 July 2023. doi:10.
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