BACKGROUND AND AIMS There are limited data on the progression of liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE) in people with type 2 diabetes mellitus (T2DM) versus those without T2DM in biopsy-proven metabolic dysfunction-associated steatotic liver disease. We examined LSM progression in participants with T2DM versus those without T2DM in a large, prospective, multicenter cohort study. APPROACH AND RESULTS This study included 1231 adult participants (62% female) with biopsy-proven metabolic dysfunction-associated steatotic liver disease who had VCTEs at least 1 year apart. LSM progression and regression were defined by a ≥20% increase and an upward or downward change, respectively, in the LSM category in the Baveno VII categories for compensated advanced chronic liver disease, compared between participants with T2DM (n = 680) versus no T2DM (n = 551) at baseline. The mean (±SD) age and body mass index were 51.8 (±12.0) years and 34.0 (±6.5) kg/m 2 , respectively. The median (IQR) time between the first and last VCTE measurements was 4.1 (2.5-6.5) years. Participants with T2DM had higher LSM progression at 4 years (12% vs. 10%), 6 years (23% vs. 16%), and 8 years (50% vs. 39%), p = 0.04. Using a multivariable Cox proportional hazards model adjusted for multiple confounders, the presence of T2DM remained an independent predictor of LSM progression (adjusted HR: 1.35, 95% CI: 1.01-1.81, p = 0.04). T2DM was not associated with LSM regression ( p = 0.71). Mean HbA1c was significantly associated with LSM progression ( p = 0.003) and regression ( p = 0.02). CONCLUSIONS Using serial VCTE data from a multicenter study of participants with biopsy-proven metabolic dysfunction-associated steatotic liver disease, we demonstrate that T2DM and HbA1c are associated with LSM progression.

中文翻译：

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经活检证实的糖尿病患者与非糖尿病患者中代谢功能障碍相关的脂肪变性疾病的肝硬度进展：一项前瞻性多中心研究。


背景和目的 通过振动控制瞬时弹性成像 (VCTE) 测量 2 型糖尿病 (T2DM) 患者与非 T2DM 患者在活检证实的代谢功能障碍相关的脂肪变性肝中的肝脏硬度测量 (LSM) 进展情况的数据有限疾病。我们在一项大型、前瞻性、多中心队列研究中比较了 T2DM 参与者与非 T2DM 参与者的 LSM 进展情况。方法和结果 本研究纳入了 1231 名成年参与者（62% 女性），这些参与者经活检证实患有代谢功能障碍相关的脂肪变性肝病，且 VCTE 间隔至少 1 年。 LSM 进展和消退的定义是，与 T2DM 参与者 (n = 680) 与非 T2DM 参与者相比，代偿性晚期慢性肝病 Baveno VII 类别中的 LSM 类别分别增加 ≥20% 和向上或向下变化(n = 551) 基线。平均（±SD）年龄和体重指数分别为51.8（±12.0）岁和34.0（±6.5）kg/m 2 。第一次和最后一次 VCTE 测量之间的中位时间 (IQR) 为 4.1 (2.5-6.5) 年。 T2DM 参与者在 4 年（12% 对 10%）、6 年（23% 对 16%）和 8 年（50% 对 39%）时 LSM 进展较高，p = 0.04。使用针对多个混杂因素进行调整的多变量 Cox 比例风险模型，T2DM 的存在仍然是 LSM 进展的独立预测因素（调整后的 HR：1.35，95% CI：1.01-1.81，p = 0.04）。 T2DM 与 LSM 回归无关（p = 0.71）。平均 HbA1c 与 LSM 进展 (p = 0.003) 和回归 (p = 0.02) 显着相关。 结论 使用来自一项多中心研究的系列 VCTE 数据，该研究的受试者患有活检证实的代谢功能障碍相关的脂肪变性肝病，我们证明 T2DM 和 HbA1c 与 LSM 进展相关。