Introduction & Objective: To propose a non-invasive index for detecting patients with T2DM at risk of significant liver fibrosis and cirrhosis in primary care.
Methods: Five cohorts consist of 38,160 adults with T2DM were enrolled to develop and validate a non-invasive index for evaluating significant liver fibrosis and cirrhosis (Figure A).
Results: Risk factors including Aspartate transaminase and boDy mass inDex were fitted to develop a test, termed the ADD index (available at: https://chess.nuist.edu.cn/consult/gzconsult/add_index). Using transient elastography (TE) as the reference, the ADD index performed better than FIB-4 and NFS for significant fibrosis (Figure B). A cutoff of 0 of the ADD index was selected to stratify patients into low- and high-risk group that should receive TE. AUC of the ADD index followed by TE was significantly higher than that of FIB-4 and NFS followed by TE (Figure B). Notably, using the ADD index combined with TE resulted in 11% cost savings compared to use TE alone. Compared with patients in low-risk group, those in high-risk group had a 2.90-fold (95% CI:1.44-5.82, P < 0.01) risk for cirrhosis (Figure C).
Conclusions: The non-invasive ADD index can be applied to screen significant fibrosis and cirrhosis in patients with T2DM in primary care, and promoting those in high-risk group to further consult a hepatologist in secondary care.
X. Qi: None. D. You: None. J. Shen: None. C. Liu: None. Y. Chen: None. M. Zheng: None. X. Zhou: None. M. Huang: None. X. Liang: None. T. Deng: None. C. Sun: None. X. Liang: None. H. Wan: None. Y. Wang: None. Y. Zhu: None. F. Lv: None. T.T. Zhou: None. S. Liu: None. X. Wang: None. X. Liu: None. R. He: None. J. Li: None. Y. Zhao: None. V.W. Wong: Consultant; AbbVie Inc., Boehringer-Ingelheim, Echosens, Gilead Sciences, Inc. Research Support; Gilead Sciences, Inc. Consultant; Intercept Pharmaceuticals, Inc., Inventiva Pharma, Novo Nordisk, Pfizer Inc., Sagimet Biosciences.
