Two‐tier screening approach for liver fibrosis stratification in outpatients with type 2 diabetes mellitus: A multicenter cross‐sectional study
Authors' conclusion
MASLD and significant liver fibrosis are common in older patients with T2DM. Fibrosis risk stratification using FIB-4, followed by VCTE, is a good strategy in real-world settings. However, relying solely on FIB-4 may fail to identify some patients with advanced disease, particularly those with increased body weight and elevated serum aminotransferase levels.
Study context
- Population
- Italian older outpatients with T2D who underwent vibration-controlled transient elastography (VCTE) with liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) assessment
- Participants
- 1,203 outpatients
- Outcome
- Prevalence and severity of MASLD (CAP ≥248 dB/m); significant liver fibrosis (LSM ≥8 kPa), cACLD (LSM ≥10 kPa), CSPH (LSM ≥25 kPa or LSM ≥20 kPa and platelet count <150 000/mm³)
Methodological detailsmulticenter, retrospective
- Multicenter
- Retrospective
Main finding
As reported in the abstract
Prevalence
MASLD
71.3%
Significant liver fibrosis
21.1%
Compensated advanced chronic liver disease (cACLD)
11.7%
Clinically significant portal hypertension (CSPH)
1.7%
Observational data: associations, not effects.
Further findings
Predictors of significant liver fibrosis
| aOR (95% CI) | ||
|---|---|---|
| Increased body weight | 3.34 (1.75–6.39) | |
| Elevated ALT levels | 1.54 (1.01–2.36) | |
| 0.10.31310Adjusted odds ratio (log scale) |
| Outcome | Values |
|---|---|
| FIB-4 index performance for detecting LSM≥8 kPa | FIB-4 index Sensitivity 50.4% · Specificity 66.3% · NPV 83.3% · PPV 28.6% |
- FIB-4 index performance for detecting LSM≥8 kPa — Normal FIB-4 index with LSM <8 kPa
- 629 (83.3%)
- FIB-4 index performance for detecting LSM≥8 kPa — Normal FIB-4 index with LSM≥8 kPa
- 126 (16.7%)
Original publication
Two‐tier screening approach for liver fibrosis stratification in outpatients with type 2 diabetes mellitus: A multicenter cross‐sectional study. Diabetes Obes Metab. Published 2 November 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →