Background: Fibrosis-4 (FIB-4) index is recommended by the American Diabetes Association Standard of Care 2024 for liver fibrosis screening in T2D. While the association between FIB-4 and increased cardiovascular disease has been established, its impact on the progression of chronic kidney disease (CKD) remains uncertain. This study aims to assess the influence of liver fibrosis, as measured by FIB-4, on CKD progression in patients with T2D and MAFLD.
Methods: The prospective cohort study enrolled 244 patients with both T2D and MAFLD. At baseline, FIB-4 was calculated based on several laboratory tests (AST/ALT/Platelets). The primary outcome was the progression of CKD, defined as a change of at least one CKD stage or incidence of macroalbuminuria or new-onset end-stage renal disease.
Results: The baseline characteristics are presented in Table 1. Over a median follow-up period of 2.1 years, 31 (12.7%) patients developed CKD progression. In multivariable Cox model, each unit increase in FIB-4 was associated with a 1.72-fold higher risk (95% CI:1.09-2.71; P=0.019) of CKD progression. Furthermore, compared with the patients in tertile 1, the adjusted-HR of CKD progression was 3.14 (95% CI: 0.80-12.25, P=0.100) and 4.90 (95% CI: 1.34-17.96, P=0.017) for those in tertile 2 and tertile 3, respectively.
Conclusion: In this cohort study of patients with T2D and MAFLD, FIB-4 was found to be an independent predictor of CKD.
C. Zhang: None. W. Suyuan: None.
Science and Technology Project of Tibet Autonomous Region (XZ202201ZR0037G)
