The development of cardiovascular disease or cancer is correlated with higher FIB-4 in patients with T2DM

Katerina Stefanaki; Dimitrios Karagiannakis; Petrea Foteini; Panagiota Zacharaki; Alexandra Giannou; Olympia Michalopoulou; Paraskevi Kazakou; Theodora Psaltopoulou; Vasiliki Vasileiou; Stavroula Paschou

doi:10.1530/endoabs.99.P259

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Endocrine Abstracts (2024) 99 P259 | DOI: 10.1530/endoabs.99.P259

ECE2024 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (130 abstracts)

The development of cardiovascular disease or cancer is correlated with higher FIB-4 in patients with T2DM

Katerina Stefanaki ¹ , Dimitrios Karagiannakis ² , Petrea Foteini ³ , Panagiota Zacharaki ¹ , Alexandra Giannou ³ , Olympia Michalopoulou ¹ , Paraskevi Kazakou ¹ , Theodora Psaltopoulou ¹ , Vasiliki Vasileiou ³ & Stavroula Paschou ¹

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¹Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece., Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Athens, Greece; ²Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece, Academic Department of Gastroenterology; ³Alexandra Hospital, Athens, Greece., Department of Endocrinology

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common feature of type 2 diabetes mellitus (T2DM). Liver fibrosis has been associated with an increased risk of cardiovascular diseases (CVD).

Aim: To investigate whether the fibrosis 4 index (FIB-4), a non-invasive marker of liver fibrosis, is associated with CVD or cancer in patients with T2DM.

Methods: Two hundred and nine consecutive T2DM patients were retrospectively evaluated. The mean time from the diagnosis to the first visit to our diabetes center was 9.83±8.6 years (median: 8.2 years; IQR: 12).

Results: One hundred and thirty-two (63.2%) patients were male and 77 (36.8%) were female. The mean age, body mass index (BMI), glycated hemoglobin (HbA1c), and FIB-4 were 64.3±11 years, 30.5±5.8 kg/m², 7.8±2, and 1.15±0.5, respectively. One hundred and fifty (71.8%) patients had FIB-4 <1.3, and 59 (28.2%) had FIB-4 >1.3. Patients with CVD at the first visit were significantly older compared to patients without CVD (68.9±8.4 vs 62.9±11.4, respectively; P<0.001), while they had substantially higher FIB-4 (1.26±0.54 vs 1.08±0.51, respectively; P=0.007). Patients with cancer of any type at the first visit were older (68.2±9.5 vs 64.4±10.9 years, P=0.098), having significantly higher FIB-4 (1.37±0.6 vs 1.1±0.5, P=0.004) compared to those without cancer. A significant correlation was revealed between FIB-4> 1.3 and the presence of CVD (χ 2=4.92, P=0.027) or the presence of cancer (χ 2=7.603, P=0.006), respectively. In the multivariate analysis, the presence of CVD was found to be independently associated with sex (male: OR 0.261, 95% CI 0.095-0.717; P= 0.009), age (OR 1.057, 95% CI 1.008- 1.108; P= 0.021), and hypertension (OR 6.146, 95% CI 2.442-15.471; P<0.001).

Conclusion: T2DM patients who develop CVD or cancer are older with higher FIB-4. Older female patients with a history of hypertension are at a higher risk of developing CVD.