Fibrosis-4 Index Is Closely Associated with Arterial Damage and Future Risk of Coronary Heart Disease in Type 2 Diabetes

Abstract

This study evaluated the association between fibrosis-4 (FIB 4) index and arterial damage or future risk of coronary heart disease (CHD) in type 2 diabetes. The study subjects were 253 patients with type 2 diabetes. The FIB4 index, as a marker of hepatic fibrosis based on age, aspartate aminotransferase and alanine aminotransferase levels, and platelet count, was calculated for all subjects. Carotid intima-media thickness (IMT), carotid artery calcification (CAC), and aortic arch calcification (AAC) grade (0–2) were assessed as atherosclerotic variables. The Suita score was calculated as the future risk of coronary heart disease (CHD). We assessed whether the FIB4 index was associated with both atherosclerotic variables and the Suita score. FIB4 index was significantly associated with IMT (r = 0.241, P < 0.001 ) and Suita score (r = 0.291, P < 0.001 ). Subjects with CAC showed a significantly higher FIB4 index score compared to subjects without (1.70 ± 0.74 and 1.24 ± 0.69, respectively, P < 0.001 ), whereas the FIB4 index was significantly elevated with a higher grade of AAC (1.24 ± 0.74, 1.56 ± 0.66, and 1.79 ± 0.71, respectively, P < 0.001 ). Linear regression analysis adjusted for clinical characteristics indicated that the FIB4 index was positively associated with IMT, Suita score, CAC, and AAC grade (β = 0.241, P = 0.004 ; β = 2.994, P < 0.001 ; β = 0.139, P = 0.001 ; and β = 0.265, P < 0.001 , respectively). FIB4 index is closely associated with arterial damage and future risk of CHD in type 2 diabetes.

Association between Major Adverse Cardiovascular Events and the Liver Fibrosis Score in Patients with and without Coronary Artery Disease: From the FU-CCTA Registry

“…There may be a similar relationship between the heart and the liver, through a “cardio-hepatic syndrome” [ 2 , 3 ]. Recently, there have been several reports on the association between hepatic fibrosis and cardiovascular disease including coronary artery disease (CAD) [ 4 , 5 , 6 , 7 , 8 ], although the number of papers is small. A history of cardiovascular disease in 6087 patients without known liver disease who had participated in an annual health checkup examination was significantly more common in subjects with a high fibrosis-4 index (FIB-4I), which is an index of the severity of liver fibrosis [ 4 ].…”

“…A history of cardiovascular disease in 6087 patients without known liver disease who had participated in an annual health checkup examination was significantly more common in subjects with a high fibrosis-4 index (FIB-4I), which is an index of the severity of liver fibrosis [ 4 ]. FIB4-I is closely associated with CAD in type 2 diabetes mellitus (DM) [ 5 ] and in metabolic-associated fatty liver disease [ 6 ]. FIB-4I is a valuable biomarker for predicting not only liver-related events but also extrahepatic cancers and major adverse cardiovascular events (MACEs) [ 7 ].…”