SFEIES24 Poster Presentations Diabetes & Metabolism (68 abstracts)
Assessing the prevalence of MASLD in a cohort of patients attending the diabetes clinic in a single centre - using the fibrosis-4 (FIB-4) index for liver fibrosis
Julie Okiro 1 , Ibrahim Ibrahim 1 , Niamh Kyne 1 , Waqar Khan 1 , Aneel Vaswani 1 , Robert McEvoy 1 , Hannah Forde 1,2 & Diarmuid Smith 1,2
1Beaumont Hospital, Dublin, Ireland; 2RCSI, Dublin, Ireland
The prevalence of Metabolic Associated Steatotic Liver Disease (MASLD) is approximately 55% in patients with Type 2 diabetes (T2DM). The EASL-EASD-EASO guidelines recommend screening patients with T2DM for MASLD. Fibrosis-4 Index (FIB-4) is a simple tool used to screen for MASLD in T2DM. FIB-4 scores are characterised as; low (<1.3), moderate (1.3 – 2.67) or high risk (>2.67). The aim of the audit was to screen a consecutive number of patients attending the out-patient clinic with T2DM with the FIB 4 score to determine risk of MASLD.
Methods: Consecutive patients attending the out-patient clinic in April 2024 were included. Data including demographics, year of diagnosis, medications, body mass index, haemoglobin A1C and laboratory values were collected using the Beaumont Hospital electronic patient record (CELLMA) and laboratory database. FIB-4 score was calculated using the age adjusted formula, age × AST (IU/l)/platelet count (× 109/l) × √ALT (IU/l).
Results: 49 patients were included. Average age was 66 years; one third were female. BMI was 29.97kg/m2 ±5.54; 40% had a BMI greater than 30kg/m2. The average FIB-4 score was 1.33 ±0.8. 29 patients were low risk, 17 were moderate and 6 were high risk.
| Low risk (n = 29) | Moderate to high risk (n = 20) | |
| Percent of total (n 49) | 59 | 41 |
| Age (mean) | 62 | 72 |
| BMI (mean, in kg/m2) | 29.9±4.9 | 30±6.7 |
| Duration of diabetes (years) | 15.18 | 14 |
| Metformin (%) | 90 | 90 |
| Sulphonylurea (%) | 45 | 40 |
| SGLT2i (%) | 66 | 50 |
| DPP4i (%) | 38 | 40 |
| Pioglitazone (%) | 3 | 0 |
| GLP1RA (%) | 41 | 30 |
| Insulin (%) | 31 | 15 |
| Comparison between risk groups and their baseline characteristics | ||
Conclusion: This audit demonstrates that 40% of patients with T2DM merited referral for fibroscan or to hepatology. Changes are needed to encourage the routine use of the FIB-4 scoring system in patients with T2DM, in particular now that medications such as GLP-1RA therapy may benefit patients with MASLD.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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