Retinopathy as a predictive indicator for significant hepatic fibrosis according to T2DM status: A cross-sectional study based on the national health and nutrition examination survey data

Jinze Li; Yi Xiang; Jiahao Han; Youfang Gao; Ruiying Wang; Zihe Dong; Huihui Chen; Ruixia Gao; Chuan Liu; Gao-Jun Teng; Xiaolong Qi

Annals of Hepatology (Jul 2024)

Retinopathy as a predictive indicator for significant hepatic fibrosis according to T2DM status: A cross-sectional study based on the national health and nutrition examination survey data

Jinze Li,
Yi Xiang,
Jiahao Han,
Youfang Gao,
Ruiying Wang,
Zihe Dong,
Huihui Chen,
Ruixia Gao,
Chuan Liu,
Gao-Jun Teng,
Xiaolong Qi

Affiliations

Jinze Li: Institute for AI in Medicine, School of Artificial Intelligence, Nanjing University of Information Science and Technology, Nanjing 210044, Jiangsu Province, China
Yi Xiang: Department of Oncology, The First Affiliated Hospital, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China; Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China
Jiahao Han: Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China
Youfang Gao: Department of Infectious Disease, The People's Hospital of Bozhou, Bozhou 236800, Anhui Province, China
Ruiying Wang: The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China
Zihe Dong: The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China
Huihui Chen: Department of Ultrasound, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, Jiangsu Province, China
Ruixia Gao: Medical School, Southeast University, Nanjing, 210009, Jiangsu Province, China
Chuan Liu: Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China
Gao-Jun Teng: Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, Jiangsu Province, China
Xiaolong Qi: Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China; Corresponding author.

Journal volume & issue: Vol. 29, no. 4
p. 101478

Abstract

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Introduction and Objectives: Type 2 Diabetes Mellitus (T2DM), a prevalent metabolic disorder, often coexists with a range of complications, with retinopathy being particularly common. Recent studies have shed light on a potential connection between diabetic retinopathy (DR) and hepatic fibrosis, indicating a possible shared pathophysiological foundation in T2DM. This study investigates the correlation between retinopathy and hepatic fibrosis among individuals with T2DM, as well as evaluates the diagnostic value of DR for significant hepatic fibrosis. Materials and Methods: Our cross-sectional analysis incorporated 5413 participants from the National Health and Nutrition Examination Survey (NHANES) 2005-2008. The Fibrosis-4 score (FIB-4) classified hepatic fibrosis into different grades (F0-F4), with significant hepatic fibrosis marked as F2 or higher. Retinopathy severity was determined using retinal imaging and categorized into four levels. The analysis of variance or Chi-square tests facilitated group comparisons. Additionally, the receiver operating characteristic (ROC) analysis appraised the predictive accuracy of retinopathy for significant hepatic fibrosis in the T2DM population. Results: Among 5413 participants, the mean age was 59.56 ± 12.41, with 50.2% male. And 20.6% were diagnosed with T2DM. Hepatic fibrosis grading was positively associated with retinopathy severity (OR [odds ratio]: 1.521, 95%CI [confidence interval]: 1.152-2.008, P = 0.003) across the entire population. The association was amplified in the T2DM population according to Pearson's analysis results. The ROC curve demonstrated retinopathy's diagnostic capacity for significant hepatic fibrosis in the T2DM population (AUC [area under curve] = 0.72, 95%CI: 0.651-0.793, P < 0.001). Conclusions: Retinopathy could serve as an independent predictor of significant hepatic fibrosis in T2DM population. Ophthalmologists are advised to closely monitor T2DM patients with retinopathy.

Published in Annals of Hepatology

ISSN: 1665-2681 (Print); 2659-5982 (Online)
Publisher: Elsevier
Country of publisher: Spain
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine
Website: https://www.journals.elsevier.com/annals-of-hepatology

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