Predictors of liver fibrosis progression in cohort of type 2 diabetes mellitus patients with MASLD.
Assim A Alfadda, Adel N Alqutub, Suphia M Sherbeeni, Abdullah S Aldosary, Saleh A Alqahtani, Arthur Isnani, Rukhsana Gul, Mohammad S Khaleel, Sara M Alqasim, Abdulrahman M Almaghamsi
Author Information
Assim A Alfadda: Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia. Electronic address: aalfadda@ksu.edu.sa.
Adel N Alqutub: Department of Gastroenterology and Hepatology, King Fahad Medical City, Riyadh, Saudi Arabia.
Suphia M Sherbeeni: Tadaw Medical Complex and Day Surgery Center, Riyadh, Saudi Arabia.
Abdullah S Aldosary: Department of Medical Imaging, King Fahad Medical City, Riyadh, Saudi Arabia.
Saleh A Alqahtani: Liver Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA.
Arthur Isnani: Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Rukhsana Gul: Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Mohammad S Khaleel: Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Sara M Alqasim: Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Abdulrahman M Almaghamsi: Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia.
AIM: To investigate predictors of liver fibrosis progression in patients with type 2 diabetes mellitus (T2DM) over a minimum follow-up duration of three years. METHODS: Two hundred and thirty-three patients completed the follow-up period and their clinical, laboratory and liver FibroScan data are reported. Patients were categorized into progressors 42 (18.0 %) and non-progressors 191 (82.0 %) based on liver fibrosis progression. Factors influencing fibrosis progression were identified by comparing these groups. RESULTS: Progressors showed significantly increased aspartate aminotransferase (AST) (p = 0.010), increased alkaline phosphatase (ALP) (p = 0.001) and decreased platelet count (p = 0.002). Non-progressors exhibited significant decreases in diastolic blood pressure (DBP) (p = 0.050), body mass index (BMI) (p < 0.001), waist circumference (p < 0.001), gamma-glutamyl transferase (GGT) (p < 0.001), albumin (p < 0.001), alanine aminotransferase (ALT) (p = 0.022), glycosylated haemoglobin (HbA1c) (p = 0.002) and fasting blood sugar (FBS) (p = 0.030) with increase in HDL-cholesterol (p < 0.001), creatinine (p < 0.001), bilirubin (p < 0.001), and ALP (p = 0.007). Baseline parameters predictive of liver fibrosis progression included elevated AST and reduced platelet count. Delta changes from baseline to follow-up revealed that increases in ALP, BMI, waist circumference, and reduction in platelet count were correlated with fibrosis progression. Use of GLP-1 receptor agonist was associated with reduced progression. CONCLUSION: In conclusion, increase in ALP and waist circumference and reduction in platelet count are predictive of liver fibrosis progression in patients with T2DM. GLP-1 receptor agonists use seems to have a promising protective effect against liver fibrosis progression. CLINICALTRIALS: govID:NCT05697991.
