Abstract
Background
Metabolic dysfunction–associated steatotic liver disease (MASLD) commonly affects patients with Type 2 diabetes mellitus (T2DM). Fibrosis‐4 (FIB‐4) has been linked to chronic kidney disease (CKD) in patients with MASLD; however, its association with CKD in broader, not preselected for MASLD, T2DM populations remains unclear.
Aim
To investigate the association of FIB‐4 with CKD in unselected patients with T2DM and compare its discriminatory ability with that of HellenicSCORE II and aspartate aminotransferase‐to‐platelet ratio index (APRI).
Methods
We retrospectively analyzed data from consecutive patients with T2DM. Characteristics and baseline laboratory results were recorded.
Results
A total of 214 patients (mean age 67.6 ± 10.3 years) were enrolled, including 158 (73.8%) males and 56 (26.2%) females. Ninety‐six (44.8%) had normal kidney function, and 54 (25.2%) had CKD at enrollment. Those with CKD were significantly older (
p
= 0.002) and had higher scores on the HellenicSCORE II (
p
= 0.004), APRI (
p
= 0.001), and FIB‐4 (
p
p
p
= 0.008) and FIB‐4 (OR: 10.4, 95% CI: 2–54.1;
p
= 0.005) were independently associated with CKD. Among the evaluated scores, FIB‐4 demonstrated the highest numerical AUROC for identifying CKD (0.769; 95% CI: 0.668–0.869), compared with APRI (0.668; 95% CI: 0.558–0.778) and HellenicSCORE II (0.651; 95% CI: 0.544–0.757).
Conclusions
FIB‐4 was independently associated with the presence of CKD in patients with T2DM and demonstrated the highest numerical AUROC among the evaluated scores.