SynthesisClinical and molecular hepatology2024
Diagnostic accuracy of the Fibrosis-4 index for advanced liver fibrosis in nonalcoholic fatty liver disease with type 2 diabetes: A systematic review and meta-analysis.
Synthesis in Clinical and molecular hepatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Impact of a high dietary fiber cereal meal intervention on the progression of liver fibrosis in T2DM with MASLD.Frontiers in endocrinology · 2025Trial
- The risk of cardiovascular events in metabolic dysfunction-associated steatotic liver disease according to fibrosis stage and diabetes status: A cohort study.Hepatology communications · 2026Article
- Metabolic Dysfunction-Associated Steatotic Liver Disease and Obesity: Pathogenesis, Diagnostics, Risk Stratification, and Therapeutic Approach.The Kaohsiung journal of medical sciences · 2026Review
- Cell-free DNA fragmentomes for noninvasive detection of liver cirrhosis and other diseases.Science translational medicine · 2026Article
- FibroX: a machine learning model for detecting and prognosticating advanced fibrosis in metabolic dysfunction-associated steatotic liver disease.Translational gastroenterology and hepatology · 2026Article
- Diagnostic accuracy of the Fibrosis-4 (FIB-4) index for advanced liver fibrosis in Qatari patients with MASLD: Comparison with liver biopsy and FibroScan.Qatar medical journal · 2026Article
- Metabolic dysfunction-associated steatotic liver disease in Cushing's syndrome: prevalence, determinants, and changes after remission.Frontiers in endocrinology · 2026Article
- Assessing the risk of metabolic dysfunction-associated steatotic liver disease in type 2 diabetes: is the Fibrosis-4 index still a reliable tool?Hepatobiliary surgery and nutrition · 2025Article
- Association between fibrosis-4 index and coronary heart disease: a population-based study.BMC cardiovascular disorders · 2025Article
- Age serves as the silent architect of FIB-4's precision in unveiling advanced hepatic fibrosis in MASLD with T2DM: Correspondence to letter to the editor on "Diagnostic accuracy of the fibrosis-4 index for advanced liver fibrosis in nonalcoholic fatty liver disease with type 2 diabetes: a systematic review and meta-analysis".Clinical and molecular hepatology · 2025Article
- The fibrosis-4 index for advanced liver fibrosis in NAFLD with T2DM: Half a loaf is better than no bread.Clinical and molecular hepatology · 2025Article
- Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study.BMJ open gastroenterology · 2024Article
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Authors and funding
11 authors.
Funding
Abstract
BACKGROUND/
aimsThe Fibrosis-4 index (FIB-4) is a noninvasive test widely used to rule out advanced liver fibrosis (AF) in patients with nonalcoholic fatty liver disease (NAFLD). However, its diagnostic accuracy in NAFLD patients with type 2 diabetes mellitus (T2DM) is controversial due to the high prevalence of AF in this population.
methodsResearch focusing on the diagnostic accuracy of FIB-4 for liver fibrosis as validated by liver histology in NAFLD patients with T2DM was included, and 12 studies (n=5,624) were finally included in the meta-analysis. Sensitivity, specificity, hierarchical summary receiver operating characteristic (HSROC), positive predictive values (PPVs), and negative predictive values (NPVs) at low cutoffs (1.3-1.67) and high cutoffs (2.67-3.25) for ruling in and out AF were calculated.
resultsAt low cutoffs, the meta-analysis revealed a sensitivity of 0.74, specificity of 0.62, and HSROC of 0.75. At high cutoffs, the analysis showed a sensitivity of 0.33, specificity of 0.92, and HSROC of 0.85, suggesting FIB-4 as useful for identifying or excluding AF. In subgroup analyses, high mean age and F3 prevalence were associated with lower sensitivity. The calculated NPV and PPV were 0.82 and 0.49 at low cutoffs, whereas the NPV was 0.28 and the PPV was 0.70 at high cutoffs. There were insufficient estimated NPVs <0.90 at a hypothesized prevalence of AF >30% at an FIB-4 cutoff range of 1.3-1.67.
conclusionCollectively, FIB-4 has moderate diagnostic accuracy for identifying or excluding AF in NAFLD patients with T2DM, but more evidence must be accumulated due to the limited number of currently reported studies and their heterogeneity.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.