Namakchian Maryam, Rabizadeh Soghra, Seifouri Sara, Asadigandomani Hassan, Bafrani Melika Arab, Seifouri Kiana, Avanaki Foroogh Alborzi, Rajab Armin, Nakhjavani Manouchehr, Esteghamati Alireza
Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784, Iran.
Departments of Gastroenterology and Hepatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Diabetol Metab Syndr. 2023 Mar 25;15(1):57. doi: 10.1186/s13098-023-01031-y.
Metabolic-associated fatty liver disease (MAFLD), one of the most common liver diseases, is detected in patients with concomitant hepatic steatosis and Type 2 Diabetes (T2D). We looked into the relationship between Fibrosis-4 (FIB-4) index and coronary artery diseases (CAD) in patients with MAFLD, to further look into the efficiency of FIB-4 in screening for CAD among patients with MAFLD.
In this study, we included 1664 patients with MAFLD (T2D, who also had hepatic steatosis) during 2012-2022 and divided them into 2 groups; CAD and non-CAD. Demographic, Anthropometric indices, liver function tests, lipid profile and FIB-4 index of all patients were evaluated and compared.
Among the 1644 patients (all have MAFLD), 364(21.4%) had CAD. Patients with MAFLD and CAD were more probable to be hypertensive, have longer duration of diabetes and be older (with p-values < 0.001). After adjustment for confounding factors, in a multivariable logistic regression model, FIB4 showed a significant independent relationship with concomitant MAFLD and CAD. Upper Tertile FIB-4 had an odds ratio of 3.28 (P-value = 0.002) to predict CAD. Furthermore, in Receiver Operating Characteristic (ROC) Curve analysis with the maximum Youden Index, a FIB-4 cut-off of 0.85 (AUC = 0.656, 95% CI 0.618-0.693, P < 0.001) noted to predict CAD in patients with MAFLD.
This study showed that the FIB-4 score independently correlates with CAD in patients with MAFLD.
代谢相关脂肪性肝病（MAFLD）是最常见的肝脏疾病之一，在伴有肝脂肪变性和2型糖尿病（T2D）的患者中被发现。我们研究了MAFLD患者中纤维化-4（FIB-4）指数与冠状动脉疾病（CAD）之间的关系，以进一步探讨FIB-4在MAFLD患者中筛查CAD的效率。
在本研究中，我们纳入了2012年至2022年期间的1664例MAFLD患者（T2D患者，同时伴有肝脂肪变性），并将他们分为两组：CAD组和非CAD组。对所有患者的人口统计学、人体测量指标、肝功能检查、血脂谱和FIB-4指数进行评估和比较。
在1644例（均患有MAFLD）患者中，364例（21.4%）患有CAD。MAFLD和CAD患者更有可能患有高血压、糖尿病病程更长且年龄更大（p值<0.001）。在调整混杂因素后，在多变量逻辑回归模型中，FIB4显示出与MAFLD和CAD同时存在显著的独立关系。FIB-4上三分位数预测CAD的比值比为3.28（P值=0.002）。此外，在具有最大约登指数的受试者工作特征（ROC）曲线分析中，FIB-4临界值为0.85（AUC=0.656，95%CI 0.618-0.693，P<0.001）时可预测MAFLD患者的CAD。
本研究表明，FIB-4评分与MAFLD患者的CAD独立相关。
