Lipids & metabolic liver disease
Liver Stiffness Measurement and All-Cause Mortality in Individuals With Diabetes
Authors' conclusion
In this cohort study, LSM was an independent risk factor for all-cause mortality in individuals with diabetes, even after a relatively short follow-up. Implementing LSM to screen for liver fibrosis as part of routine diabetes management could aid in early identification of patients with high mortality risk.
Study context
- Population
- Adults with complete vibration-controlled transient elastography (VCTE) and controlled attenuation parameter (CAP) data, NHANES 2017–2018, linked to National Death Index to December 31, 2019; liver disease other than MASLD excluded; mean (SEM) age 47 (1) years, 50.7% female, 14.5% with diabetes
- Participants
- 4,102 adults
- Exposure
- Diabetes with MASLD or advanced liver fibrosis vs without
- Outcome
- All-cause mortality (hazard ratios (HRs) with 95% CIs, Cox proportional hazards regression)
- Follow-up
- Mean (SEM) 24 (2) months
Methodological detailscomplex survey design with examination weights, Cox proportional hazards regression, Data analyzed from December 2024 to December 2025
- Complex survey design with examination weights
- Cox proportional hazards regression
- Data analyzed from December 2024 to December 2025
Main finding
As reported in the abstract
Died during follow-up
59 patients
1.4%
Coexistence of diabetes with MASLD (CAP ≥274 dB/m), aHR
2.77
95% CI 1.16–6.65P = .03
Diabetes with advanced liver fibrosis (liver stiffness measurement (LSM) ≥9.7 kPa), aHR
6.41
95% CI 1.03–39.85P = .047
In patients with diabetes, LSM associated with all-cause mortality after adjustment (age, sex, body mass index (BMI), HbA1c), aHR
1.06
95% CI 1.04–1.09P < .001
Observational data: associations, not effects.
Further findings
Characteristics of patients who died vs did not
- Mean (SEM) age, died vs not (P < .001)
- 62 [3] years vs 47 [1] years
- Prevalence of diabetes, died vs not (P = .01)
- 35.7% vs 14.2%
- Non-Hispanic White race, died vs not (P = .002)
- 85.1% vs 62.7%
Original publication
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