Aim: Identify relationship between different stages of liver fibrosis (LF) & N-terminal pro-B type natriuretic peptide (NT-ProBNP).

Methods: Between Oct’ 22 & Mar’ 23, 66 T2DM patients receiving dapagliflozin & waist cmf > 80 cms (F) & > 90 cms (M) irrespective of their A1c & who underwent Liver Fibroscan (Lfib) were retrospectively analysed & studied. Metavir stg classified patients: F0 (N); F1 (N - mild); F2 (Mild - mod); F3 (mod - severe); F4 (cirrhosis). LF was assessed by Lfib performed using ARFI. Exclusion: pregnancy, <3 mnth illness, hospitalisation, H/O heart disease, alcoholism & hep B, C & autoimmune hepatitis (if raised LFT). Weight-kg (W), systolic/diastolic BP (mmHg), Lipid profile mg/dl (TC, LDL, TG, HDL), LFT, Hs-CRP mg/L, NT-ProBNP pg/ml, eGFR (Cr & Cyst-C) & UACR were recorded every 2-3 mnths & data presented over 1 yr.

Statistics: ANOVA - compared means between 3 data points & stgs of LF. One-Way ANOVA followed by post-hoc Tukey test compared NT-ProBNP to LF stages & P value <0.05 was considered statistically significant (S). Baseline (B) characters: Males 86.4%, avg (age 56.88<u>+</u>8.82, W 83.72<u>+</u>11.96, SBP 134.79<u>+</u>17.46, DBP 86.61<u>+</u>11.94, A1c 7.77<u>+</u>1.54, TC 153.72<u>+</u> 46.18, LDL 86.76<u>+</u>40.29, HDL 38.86<u>+</u>8.08, TG 164.16<u>+</u>90.82, hs-CRP 2.57<u>+</u>2.83, GGT 49<u>+</u>51.96, SGPT 40.44<u>+</u>25.89, NT-ProBNP 46.65<u>+</u>45.71, UACR 33.43<u>+</u>99.55 & eGFRCys-C 84.98<u>+</u>20.55). (B) - 1 yr: S reduction seen in Wt, DBP, A1c, TC, LDL, TG, hs-CRP & SGPT. S relation was seen with stage F4 LF & NT-ProBNP (123.36<u>+</u>124.01, p-0.049) but not with other stages of LF (F0 49.67<u>+</u>42.57, F1 54.40<u>+</u>34.64, F2 17.66<u>+</u>10.38, F3 27.35<u>+</u>10.96) at the end of the study. There was no S association seen between liver enzymes & NT-ProBNP at any LF stg.

Conclusion: Severe liver fibrosis (F4) is associated with elevated NT-ProBNP in Indian patients with T2DM compared to other stages of LF despite receiving SGLT2i therapy. Further cardiac evaluation may be warranted in this population.

Disclosure

V. Gupta: None.

© 2024 by the American Diabetes Association
2024
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