Diabetes, metabolic syndrome and obesity : targets and therapy · 2026
Predictors of Hepatic Steatosis and the Limitations of the FIB-4 Index in Type 2 Diabetes: A Cross-Sectional Study.
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Saadeh Nesreen A, Obeidat Khaled A, Bani Hani Nadeem W, Darawsheh Deaa, Alrawashdeh Muayad A, Ahmad Abdelrahman K, Alnatour Rawan M, Mayyas Batool Tariq, Almomani Shaima Ahmad, Alrabadi Nasr
Аннотация
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among patients with type 2 diabetes mellitus (T2DM). Non-invasive tools (NITs) such as the FIB-4 index, are widely used for risk stratification to identify patients at higher risk of progressive liver disease. This study aimed to assess the utility of the FIB-4 index and identify stronger predictors of MASLD in a T2DM cohort.
METHODS: A retrospective cross-sectional study was conducted on 186 patients with T2DM. Hepatic steatosis was diagnosed via abdominal ultrasonography, categorizing patients into MASLD (n=100) and non-MASLD (n=86) groups. The FIB-4 index was calculated, and group comparisons were performed. A novel simplified clinical scoring system was constructed to identify independent predictors of ultrasound-confirmed steatosis.
RESULTS: Patients with MASLD exhibited significantly higher body mass index (BMI) (P < 0.001), alanine aminotransferase (ALT) (P = 0.005), Aspartate aminotransferase (AST) (P =0.05) and triglycerides (P = 0.034) compared to the non-MASLD group. The multivariate logistic regression analysis established the weight of each clinical marker. The FIB-4 index failed to significantly differentiate between the two groups (P = 0.272).
CONCLUSION: The FIB-4 index demonstrated limited diagnostic utility for MASLD in this T2DM population. Conversely, a newly derived score, incorporating readily available parameters like BMI, ALT, AST, and triglycerides, offers a highly specific, practical alternative for non-invasive MASLD screening in resource-limited primary care settings.
METHODS: A retrospective cross-sectional study was conducted on 186 patients with T2DM. Hepatic steatosis was diagnosed via abdominal ultrasonography, categorizing patients into MASLD (n=100) and non-MASLD (n=86) groups. The FIB-4 index was calculated, and group comparisons were performed. A novel simplified clinical scoring system was constructed to identify independent predictors of ultrasound-confirmed steatosis.
RESULTS: Patients with MASLD exhibited significantly higher body mass index (BMI) (P < 0.001), alanine aminotransferase (ALT) (P = 0.005), Aspartate aminotransferase (AST) (P =0.05) and triglycerides (P = 0.034) compared to the non-MASLD group. The multivariate logistic regression analysis established the weight of each clinical marker. The FIB-4 index failed to significantly differentiate between the two groups (P = 0.272).
CONCLUSION: The FIB-4 index demonstrated limited diagnostic utility for MASLD in this T2DM population. Conversely, a newly derived score, incorporating readily available parameters like BMI, ALT, AST, and triglycerides, offers a highly specific, practical alternative for non-invasive MASLD screening in resource-limited primary care settings.