Two-step clinical care pathway to predict MASLD-related advanced fibrosis and long-term outcomes in type 2 diabetes - PubMed
3 hours ago
- #Type 2 Diabetes
- #Liver Fibrosis
- #MASLD
- A two-step approach using FIB-4 followed by liver stiffness measurement (LSM) effectively stratifies risk of advanced fibrosis and liver-related events in type 2 diabetes patients with MASLD.
- In a liver biopsy cohort, applying LSM thresholds of <8 kPa (low-risk) and >12 kPa (high-risk) after FIB-4 resulted in correct classification of 71% of patients for advanced fibrosis.
- In a prognostic cohort, the two-step approach classified patients into risk groups with 5-year cumulative incidences of liver-related events of 0.7% (low-risk), 0.9% (intermediate-risk), and 11.8% (high-risk).
- Refining the classification by using LSM cut-offs of <10 kPa and >15 kPa for intermediate FIB-4 patients reduced the intermediate-risk group to 5.6% while maintaining predictive accuracy.