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纤维化 4 评分与 2 型糖尿病患者微血管并发症的关系。

Relationship between fibrosis-4 score and microvascular complications in patients with type 2 diabetes mellitus.

机构信息

University of Health Sciences, Ankara City Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.

Ankara Yildirim Beyazit University School of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey.

出版信息

Arab J Gastroenterol. 2024 Aug;25(3):269-274. doi: 10.1016/j.ajg.2024.04.001. Epub 2024 May 7.

Abstract

BACKGROUND AND STUDY AIMS

Nonalcoholic fatty liver disease is the most prevalent chronic liver disease globally and is linked to augmented susceptibility to type 2 diabetes mellitus (DM), cardiovascular disease, and microvascular complications inherent to DM, such as nephropathy, neuropathy, and retinopathy. The fibrosis-4 (FIB-4) scoring system, a noninvasive tool, is useful for predicting the extent of liver fibrosis across diverse pathologies. This study aimed to assess the potential predictive role of FIB-4 scores in microvascular complications associated with diabetes.

PATIENTS AND METHODS

The medical records of patients with type 2 DM admitted to our endocrinology clinic between February 2019 and December 2020 were retrospectively evaluated. Parameters including demographic attributes, fasting blood glucose, glycated hemoglobin, aspartate aminotransferase, alanine aminotransferase, thrombocyte levels, and microvascular complications were recorded. The FIB-4 score was computed, and patients were categorized based on these scores (<1.3 and ≥ 1.3).

RESULTS

The analysis included 312 patients with a median age of 60 (50-68 years); 39.7 % were men. The median duration of diabetes was 10 years (5-20 years), and the median FIB-4 score was 0.93 (0.63-1.34). Neuropathy, nephropathy, and retinopathy were observed in 50.6 %, 31.4 %, and 34 % of the patients, respectively. Although the FIB-4 score did not differ significantly between patients with and without neuropathy or retinopathy, patients with nephropathy exhibited higher FIB-4 scores. Notably, patients with FIB-4 scores ≥ 1.3 demonstrated a significantly higher prevalence of nephropathy. Logistic regression analysis demonstrated that higher FIB-4 scores were significantly associated with an increased risk of nephropathy.

CONCLUSION

The FIB-4 score is a cost-effective and straightforward tool with potential applicability in predicting nephropathy in individuals with type 2 DM.

摘要

背景与研究目的

非酒精性脂肪性肝病是全球最常见的慢性肝病,与 2 型糖尿病(DM)、心血管疾病以及 DM 固有微血管并发症(如肾病、神经病和视网膜病变)的易感性增加有关。纤维化-4(FIB-4)评分系统是一种非侵入性工具,可用于预测各种病理的肝纤维化程度。本研究旨在评估 FIB-4 评分在与糖尿病相关的微血管并发症中的潜在预测作用。

患者与方法

回顾性评估了 2019 年 2 月至 2020 年 12 月期间在我院内分泌科就诊的 2 型糖尿病患者的病历。记录了包括人口统计学特征、空腹血糖、糖化血红蛋白、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、血小板水平和微血管并发症在内的参数。计算了 FIB-4 评分,并根据这些评分将患者分为<1.3 和≥1.3 两组。

结果

该分析共纳入了 312 名中位年龄为 60(50-68 岁)岁的患者;其中 39.7%为男性。糖尿病的中位病程为 10 年(5-20 年),中位 FIB-4 评分为 0.93(0.63-1.34)。50.6%、31.4%和 34%的患者分别出现了神经病、肾病和视网膜病变。尽管 FIB-4 评分在神经病或视网膜病变患者之间没有显著差异,但肾病患者的 FIB-4 评分较高。值得注意的是,FIB-4 评分≥1.3 的患者肾病的患病率显著更高。Logistic 回归分析表明,较高的 FIB-4 评分与肾病的风险增加显著相关。

结论

FIB-4 评分是一种具有成本效益且简单的工具,具有在 2 型糖尿病患者中预测肾病的潜在适用性。

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