Association of fibrosis index-4 (FIB-4) with chronic vascular complications of type 2 diabetes mellitus

Fibrosis-Index-4 (FIB-4) is used with a cut-off of 1.3 to exclude severe fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of this study was to examine the potential association of FIB-4 with chronic vascular complications of type 2 diabetes mellitus (T2DM). Included were 550 adults (271 men) with T2DM, mean age of 67.88±11.46 years and median T2DM duration of 15 (9.75-22) years. FIB-4 was calculated and chronic vascular complications were recorded. Participants with FIB-4>1.3 were compared with those having FIB-4≤1.3. The former exhibited significantly more frequent peripheral neuropathy (corrected odds ratio [cOR]: 26.48, 95% confidence interval [CI]: 16.81-41.71, p<0.001), chronic kidney disease (cOR: 33.75, 95% CI: 19.55-58.28, p<0.001), retinopathy (cOR: 22.42, 95% CI: 14.22-35.34, p<0.001), stroke (cOR: 2.85, 95% CI: 1.56-5.21, p<0.001), coronary artery disease (cOR: 6.20, 95% CI: 4.25-9.04, p<0.001) and peripheral arterial disease (cOR: 4.60, 95%-CI: 2.62-8.07, p<0.001) than the latter. Peripheral neuropathy was staged as absent, mild and moderate-severe, based on the Neuropathy Disability-Score (NDS). FIB-4 score was associated with increased clinical severity of peripheral neuropathy (p<0.001).