FIB-4 index-based surveillance for advanced liver fibrosis in diabetes patients

Nozomi Kawata, Hirokazu Takahashi, Shinji Iwane, Kanako Inoue, Motoyasu Kojima, Michiko Kohno, Kenichi Tanaka, Hitoe Mori, Hiroshi Isoda, Satoshi Oeda, Yayoi Matsuda, Yoshiaki Egashira, Jyunichi Nojiri, Hiroyuki Irie, Yuichiro Eguchi, Keizo Anzai

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Liver fibrosis is associated with lifestyle-related diseases, including diabetes. The identification of diabetic patients with severe liver fibrosis is important, but a simple and reliable diagnostic procedure remains to be determined. We conducted an observational study to evaluate the performance of a FIB-4 index-based screening strategy for the diagnosis of advanced liver fibrosis in patients with diabetes or prediabetes. Two hundred and forty-two patients underwent abdominal imaging in our Study. According to the abdominal imaging findings, fatty liver, liver cirrhosis, and hepatocellular carcinoma were defined, and their association with FIB-4 index evaluated. The prevalences of liver cirrhosis and hepatocellular carcinoma in patients with a high (≥ 2.67; liver cirrhosis: 42.9%, hepatocellular carcinoma: 14.3%) FIB-4 index were significantly higher than in those with an intermediate (1.3 ≤ FIB-4 < 2.67; liver cirrhosis: 1.6%, hepatocellular carcinoma: 0.8%) or low FIB-4 index (< 1.3; liver cirrhosis: 1.2%, hepatocellular carcinoma: 0%). The diagnostic accuracy, specificity, and sensitivity of the FIB-4 index for the diagnosis of liver cirrhosis or hepatocellular carcinoma were 84.3%, 85.5%, and 89.3%, respectively, with an optimized cut-off value of 2.96 (sensitivity = 0.86, specificity = 0.98). Using an optimized cut-off value, FIB-4 index might be useful to identify liver cirrhosis or hepatocellular carcinoma in diabetes patients with high diagnostic accuracy.

Original languageEnglish
Pages (from-to)118-125
Number of pages8
JournalDiabetology International
Issue number1
Publication statusPublished - Jan 2021

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism


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