Why the study?
The relationship between advanced liver fibrosis estimated by the FIB-4 index and ASCVD burden and outcomes in adults with T2DM remained unclear.
Does a higher Fibrosis-4 (FIB-4) index predict greater ASCVD burden, MACE, and mortality in adults with Type 2 Diabetes?
Population
8,900 adults with T2DM receiving care at Weill Cornell Medicine
Comparison
Low (<1.3) vs indeterminate (1.3-2.67) vs high (>2.67) FIB-4 index
Design
Unicenter retrospective registry study
Key result
In adults with T2DM, a higher FIB-4 index was associated with a stepwise increase in the prevalence of MACE (53.6% to 70.3%) and all-cause mortality (4.4% to 14.2%) (p≤0.001).
Authors
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Supports FIB-4 as integrative marker in T2DM; leaves open incremental prognostic value beyond standard risks.
Cohort (n=8,900)
No
Does a higher Fibrosis-4 (FIB-4) index predict greater ASCVD burden, MACE, and mortality in adults with Type 2 Diabetes?
Absolute Event Rate: 70.3% vs 53.6%
p-value: p=≤0.001
In adults with T2DM, a higher FIB-4 index is significantly associated with increased prevalence of MACE, all-cause mortality, CAD, and stroke, suggesting its utility as an integrative cardiometabolic risk marker.
Manolas et al. (2026) conducted a cohort in Type 2 Diabetes (n=8,900). High Fibrosis-4 (FIB-4) index (>2.67) vs. Low FIB-4 index (<1.3) was evaluated on Major adverse cardiovascular events (MACE) (p=≤0.001). In adults with T2DM, a higher FIB-4 index was associated with a stepwise increase in the prevalence of MACE (53.6% to 70.3%) and all-cause mortality (4.4% to 14.2%) (p≤0.001).
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