Type 2 diabetes complications are associated with liver fibrosis independent of hemoglobin A1c

• Published in: Annals of hepatology Vol. 28; no. 3; p. 101087
• Main Authors: Trivedi, Hirsh D., Tran, Qua, Fricker, Zachary, Curry, Michael P., Li, Jonathan X., Lai, Michelle
• Format: Journal Article
• Language: English
• Published: Mexico Elsevier España, S.L.U 01.05.2023; Elsevier
• Subjects: Cross-Sectional Studies; Diabetes Complications - complications; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Fibrosis; Glycated Hemoglobin; Hepatic fibrosis; Hepatic steatosis; Humans; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Nonalcoholic fatty liver disease; Type 2 diabetes; Type 2 diabetes; NAFLD; TX; ALT; INR; P; LDL; Nonalcoholic fatty liver disease; HbA1c; BMI; Hepatic fibrosis; AST; CI; LSM; HCC; Hepatic steatosis; ICD; IQR; NASH; TE; BIDMC; IRB; ALD; FIB-4; ADA
• ISSN: 1665-2681; 2659-5982
• DOI: 10.1016/j.aohep.2023.101087

The association between type 2 diabetes, non-alcoholic fatty liver disease, and liver fibrosis is well established, but it is unknown whether complications of type 2 diabetes influence fibrosis levels. We defined the complications of type 2 diabetes by the presence of diabetic nephropathy, retinopathy, or neuropathy and aimed to evaluate their association with the degree of liver fibrosis measured by the fibrosis-4 (FIB-4) index. This is a cross-sectional study evaluating the association of type 2 diabetes complications with liver fibrosis. A total of 2389 participants were evaluated from a primary care practice. FIB-4 was evaluated as a continuous and categorical measure using linear and ordinal logistic regression. Patients with complications were older, had higher hemoglobin A1c, and a higher median FIB-4 score (1.34 vs. 1.12, P<0.001). On adjusted analysis, type 2 diabetes complications were associated with higher fibrosis by continuous FIB-4 score (Beta-coefficient: 0.23, 95% confidence interval [CI]: 0.004-1.65) and demonstrated increased odds of fibrosis by categorical FIB-4 score (odds ratio [OR]: 4.48, 95% CI: 1.7-11.8, P=0.003), independent of hemoglobin A1c level. The presence of type 2 diabetes complications is associated with the degree of liver fibrosis, independent of hemoglobin A1c level.