The fibrosis-4 index and its association with carotid atherosclerosis in type 2 diabetes: a cross-sectional study in China

Abstract

Abstract Background The medical community has long been concerned about the cardiovascular disease risk in patients with type 2 diabetes. While liver fibrosis scores were originally designed for application in individuals with liver steatosis, an increasing number of studies have shown that they are also associated with cardiovascular disease risk. However, the association between Fibrosis-4 (Fib-4) in liver fibrosis scores and carotid atherosclerosis (CA) in patients with type 2 diabetes remains unclear. Objective The aim of this study is to investigate the association between the Fib-4 index and CA in patients with Type 2 diabetes. Additionally, it seeks to determine whether this relationship is influenced by factors including gender, age, body mass index (BMI), hypertension, and other variables. Methods Screening based on inclusion and exclusion criteria identified 2658 hospitalized patients with type 2 diabetes. Subsequently, patients were divided into three groups according to Fib-4 values (Fib-4 0.05). The results of the ROC curve analysis indicated that the AUC for Fib-4 predicting CA was 0.602 (P < 0.001, 95% CI: 0.579–0.625), while the AUC values for increased CIMT and carotid plaques were 0.561 (P < 0.001, 95% CI: 0.540–0.583) and 0.580 (P < 0.001, 95% CI: 0.558–0.601), respectively. Conclusion Elevated Fib-4 levels (Fib-4 ≥ 1.3) are positively associated with CA in patients with type 2 diabetes, including increased CIMT and the presence of carotid plaques. As such, Fib-4 may serve as a potential biomarker for the detection of CA in patients with type 2 diabetes. However, its clinical utility needs further validation, particularly in larger sample sizes and multicenter studies.

Keywords

• Fibrosis-4
• Type 2 diabetes
• Carotid atherosclerosis
• Metabolic dysfunction-associated steatotic liver disease
• Liver fibrosis