ASSOCIATION BETWEEN THE FIB-4 INDEX AND RENAL FUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Main Article Content
Abstract
Objectives: To investigate the association between the FIB-4 index and renal function in patients with type 2 diabetes mellitus.
Subjects and methods: A descriptive cross-sectional study was conducted in 130 patients diagnosed with type 2 diabetes mellitus who attended the Outpatient Department of University Medical Center Ho Chi Minh City - Campus 2. The FIB-4 index was calculated using age, AST, ALT, and platelet count.
Results: Among 130 patients with type 2 diabetes mellitus, FIB-4 was significantly negatively correlated with eGFR (r = -0.25; p = 0.0038), total cholesterol (r = -0.29; p = 0.001), and LDL-C (r = -0.27; p = 0.002). In the multivariable linear regression model, higher FIB-4 (β = -8.36; p = 0.001) and lower hemoglobin (β = 5.17; p < 0.001) were independently associated with decreased eGFR. In the multivariable logistic regression model, FIB-4 (p = 0.005) and hemoglobin (p = 0.003) remained independent predictors of eGFR < 60 mL/min/1.73 m², with an AUC of 0.7284.
Conclusions: The FIB-4 index and hemoglobin were independently associated with impaired renal function in patients with diabetes. In clinically stable conditions and in the absence of acute liver injury, FIB-4 may serve as a simple and useful marker for early identification of chronic kidney disease risk in clinical practice.
Article Details
Keywords
FIB-4, renal function decline, type 2 diabetes mellitus.
References
[2] Mantovani A, Petracca G, Beatrice G, Csermely A, Tilg H, Byrne C.D et al. Non-alcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis. Gut, 2022, 71 (1): 156-162. doi: 10.1136/gutjnl-2020-323082
[3] Bilson J, Mantovani A, Byrne C.D, Targher G. Steatotic liver disease, MASLD and risk of chronic kidney disease. Diabetes Metab, 2024, 50 (1): 101506. doi: 10.1016/j.diabet.2023.101506
[4] Sterling R.K, Lissen E, Clumeck N, Sola R, Correa M.C, Montaner J et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology, 2006, 43 (6): 1317-1325. doi: 10.1002/hep.21178
[5] Rinella M.E, Neuschwander-Tetri B.A, Siddiqui M.S, Abdelmalek M.F, Caldwell S, Barb D et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology, 2023, 77 (5): 1797-1835. doi: 10.1097/HEP.0000000000000323
[6] Inoue H, Asahara S.I, Nakamura F, Kido Y. A high fibrosis-4 index is associated with a reduction in the estimated glomerular filtration rate in non-obese Japanese patients with type 2 diabetes mellitus. Kobe J Med Sci, 2024, 70 (1): E39-E45. doi: 10.24546/0100489395
[7] American Diabetes Association Professional Practice Committee. Diagnosis and classification of diabetes: standards of care in diabetes 2024. Diabetes Care, 2024, 47 (Suppl 1): S20-S42. doi: 10.2337/dc24-S002
[8] Inker L.A, Eneanya N.D, Coresh J, Tighiouart H, Wang D, Sang Y et al. New creatinine- and cystatin C-based equations to estimate GFR without race. N Engl J Med, 2021, 385 (19): 1737-1749. doi: 10.1056/NEJMoa2102953
[9] Saito H, Tanabe H, Kudo A et al. High FIB4 index is an independent risk factor of diabetic kidney disease in type 2 diabetes. Sci Rep, 2021, 11: 11753. doi: 10.1038/s41598-021-88285-6
[10] Seko Y, Yano K, Takahashi A et al. FIB-4 Index and diabetes mellitus are associated with chronic kidney disease in Japanese patients with non-alcoholic fatty liver disease. Int J Mol Sci, 2020, 21 (1): 171. doi: 10.3390/ijms21010171