Liver Stiffness Measurement and All-Cause Mortality in Individuals With Diabetes - PubMed

4 hours ago

Liver stiffness measurement (LSM) is recommended by the American Diabetes Association only when the Fibrosis-4 (FIB-4) index is elevated, but LSM may provide additional valuable information, especially in populations like those with type 2 diabetes where FIB-4 underperforms.
A cohort study assessed the association between liver fibrosis evaluated by LSM and increased mortality in individuals with and without diabetes, using data from the 2017-2018 National Health and Nutrition Examination Survey linked to mortality data up to December 31, 2019.
The study included 4102 adult patients, with a mean age of 47 years and 50.7% female. Diabetes was present in 14.5% of participants, and after a mean follow-up of 24 months, 1.4% had died.
Patients who died were older, had a higher prevalence of diabetes, and were more likely to be of non-Hispanic White race. The coexistence of diabetes with metabolic dysfunction-associated steatotic liver disease (MASLD) and diabetes with advanced liver fibrosis was associated with increased all-cause mortality.
In patients with diabetes, LSM, but not FIB-4 index, remained associated with all-cause mortality after adjusting for clinical variables like age, sex, BMI, and hemoglobin A1c.
The study concluded that LSM is an independent risk factor for all-cause mortality in individuals with diabetes, suggesting that implementing LSM as part of routine diabetes management could help identify patients at high mortality risk early.

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