Fibroscan Assessment of Hepatic Fibrosis in Type 2 Diabetic Patients: A Prospective Study from Southern Morocco

Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among patients with type 2 diabetes (T2DM), with a reported risk of up to 55%. It may progress to advanced fibrosis or cirrhosis. Current guidelines recommend systematic screening for liver fibrosis in this high-risk population. The aim of this study was to assess the severity and prevalence of hepatic fibrosis in T2DM patients using FibroScan, to identify associated risk factors, and to analyze the correlation with the FIB-4 score. Patients and Methods: A prospective study was conducted at Hassan II Hospital in Agadir between December 2023 and February 2025, including 100 patients with T2DM. All participants underwent abdominal ultrasound followed by FibroScan for liver stiffness measurement. Data were collected using a structured extraction form and analyzed with Jamovi software. Results: The study included 100 patients with a female predominance (74%) and a mean age of 54.6 years. Body mass index (BMI) was above 25 kg/m² in 80% of participants, with a mean BMI of 29.3 kg/m². A history of hypertension, dyslipidemia, and smoking was reported in 52%, 36%, and 20% of patients, respectively. Mean liver stiffness measured by FibroScan was 6.7 kPa. Significant hepatic fibrosis was associated with higher BMI and waist circumference, greater frequency of hepatic steatosis, longer duration of diabetes, and poor glycemic control (p < 0.05). Regarding the FIB-4 score, 74% of patients had a score <1.3, 20% between 1.3 and 2.67, and 6% >2.67. Discordance between FIB-4 and FibroScan results was observed, including false positives and false negatives. Conclusion: This study highlights the high prevalence of MASLD and hepatic fibrosis in T2DM patients. The main risk factors identified were obesity, increased waist circumference, longer diabetes duration, and poor glycemic control. Although FIB-4 is a useful initial tool, its diagnostic limitations underscore the need for cautious interpretation a