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FIB-4 index-based surveillance for advanced liver fibrosis in diabetes patients

Diabetology International volume 12, pages 118–125 (2021)Cite this article

Abstract

Liver fibrosis is associated with lifestyle-related diseases, including diabetes. The identification of diabetic patients with severe liver fibrosis is important, but a simple and reliable diagnostic procedure remains to be determined. We conducted an observational study to evaluate the performance of a FIB-4 index-based screening strategy for the diagnosis of advanced liver fibrosis in patients with diabetes or prediabetes. Two hundred and forty-two patients underwent abdominal imaging in our Study. According to the abdominal imaging findings, fatty liver, liver cirrhosis, and hepatocellular carcinoma were defined, and their association with FIB-4 index evaluated. The prevalences of liver cirrhosis and hepatocellular carcinoma in patients with a high (≥ 2.67; liver cirrhosis: 42.9%, hepatocellular carcinoma: 14.3%) FIB-4 index were significantly higher than in those with an intermediate (1.3 ≤ FIB-4 < 2.67; liver cirrhosis: 1.6%, hepatocellular carcinoma: 0.8%) or low FIB-4 index (< 1.3; liver cirrhosis: 1.2%, hepatocellular carcinoma: 0%). The diagnostic accuracy, specificity, and sensitivity of the FIB-4 index for the diagnosis of liver cirrhosis or hepatocellular carcinoma were 84.3%, 85.5%, and 89.3%, respectively, with an optimized cut-off value of 2.96 (sensitivity = 0.86, specificity = 0.98). Using an optimized cut-off value, FIB-4 index might be useful to identify liver cirrhosis or hepatocellular carcinoma in diabetes patients with high diagnostic accuracy.

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Acknowledgements

We thank Mark Cleasby, PhD, from Edanz Group (https://www.edanzediting.com/ac) for editing a draft of this manuscript.

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Affiliations

  1. Division of Metabolism and Endocrinology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga, Japan

    Nozomi Kawata, Hirokazu Takahashi, Kanako Inoue, Motoyasu Kojima, Michiko Kohno, Kenichi Tanaka, Hitoe Mori, Yayoi Matsuda & Keizo Anzai

  2. Liver Center, Saga University, Saga, Japan

    Shinji Iwane, Hiroshi Isoda, Satoshi Oeda & Yuichiro Eguchi

  3. Department of Radiology, Faculty of Medicine, Saga University, Saga, Japan

    Yoshiaki Egashira, Jyunichi Nojiri & Hiroyuki Irie

  4. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yayoi Matsuda

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  1. Nozomi Kawata
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Contributions

The involvement of each author was as follows: N.K. (1-5,7); H.T. (1,3,6,7); S.I. (1,2,7); K.I. (2,7); Mo.K. (2,7); Mi.K. (2,7); K.T. (2,7); H.M. (3,7); H.I. (3,7); S.O. (3,7); Y.M. (3,7); Y.E. (3,7); Y.E. (3,4,8); J.N. (3,4,8); H.I. (3,4,8); K.A. (1,3,6,7). Key: (1) conception and design; (2) acquisition of data; (3) analysis and interpretation of data; (4) drafting of the manuscript; (5) statistical analysis; (6) study supervision; (7) critical revision of the manuscript; (8) assistance for image interpretation. All authors read the final version of this article, approve its’ content and submission for publication. And all authors have agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Keizo Anzai.

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Kawata, N., Takahashi, H., Iwane, S. et al. FIB-4 index-based surveillance for advanced liver fibrosis in diabetes patients. Diabetol Int 12, 118–125 (2021). https://doi.org/10.1007/s13340-020-00453-7

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  • DOI: https://doi.org/10.1007/s13340-020-00453-7

Keywords

  • Complications
  • Liver fibrosis
  • Liver cancer
  • Imaging