Metabolic factors moderate the association between hepatic fibrosis and atherosclerotic cardiovascular risk in type 2 diabetes
Authors' conclusion
In T2DM patients, hepatic fibrosis caused by MASLD is associated with elevated ASCVD risks, particularly among those with hypertension, insulin resistance and elevated LDL cholesterol. It is crucial to incorporate hepatic fibrosis assessment into ASCVD risk stratification in T2DM patients with comorbid MASLD to inform early prevention of ASCVD.
Study context
- Population
- Hospitalized T2D patients with MASLD; mean age 57.81±10.23, 37% female
- Participants
- 1,238 patients
- Outcome
- Association between hepatic fibrosis (SAFE score) and 10-year ASCVD risk (ASCVD Risk Calculator)
Methodological detailsmultisite
- Multisite
Main finding
As reported in the abstract
SAFE score and 10-year ASCVD risk
- Significant association between Steatosis-Associated Fibrosis Estimator (SAFE) score and 10-year atherosclerotic cardiovascular disease (ASCVD) risk, multivariable regression adjusted for covariates
- p<0.001
- Increase in 10-year ASCVD risk score per unit increase in SAFE score
- 0.07-unit
Observational data: associations, not effects.
Further findings
Advanced fibrosis prevalence
- Advanced fibrosis present
- 25.6%
Moderators of the SAFE score–ASCVD risk association
- Greater increase in 10-year ASCVD risk score with increasing SAFE score among patients with hypertension, insulin resistance and elevated LDL-C
- ps<0.05
- No moderating effect: overweight/obesity, TG, HDL-C, uric acid, TSH, HbA1c, high-sensitivity C reactive protein
Original publication
Metabolic factors moderate the association between hepatic fibrosis and atherosclerotic cardiovascular risk in type 2 diabetes. BMJ Open Diabetes Res Care. Published 4 November 2025. doi:10.
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