{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:11:05Z","timestamp":1788520265983,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Aims<\/jats:title>\n                    <jats:p>The prognostic importance of changes in vibration\u2010controlled transient elastography (VCTE) parameters, liver stiffness measurement (LSM), and controlled attenuation parameter (CAP), in individuals with type 2 diabetes (T2D) and metabolic dysfunction\u2010associated steatotic liver disease (MASLD) is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort of 288 patients underwent 2 VCTE exams at least 2\u2009years apart, and the relative percentage changes in LSM and CAP were calculated. Outcomes were the occurrence of any liver\u2010related events (LREs), cardiovascular events (CVEs), and all\u2010cause mortality. Multivariable Cox analyses, adjusted for liver and cardiometabolic factors, assessed associations between VCTE parameters changes, both as continuous and dichotomical variables (LSM increase &gt;15% and CAP reduction &gt;10%), and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow\u2010up of 6\u2009years, there were 22 LREs, 28 CVEs, and 37 all\u2010cause deaths. For LREs, baseline LSM was the strongest predictor, but LSM increases added further prognostic value (hazard ratio [HR]: 1.5 [1.0\u20132.1], 1\u2010SD increment). For CVEs, both LSM increase (HR: 1.7 [1.3\u20132.3]) and CAP reduction (HR: 1.5 [1.0\u20132.3], 1\u2010SD decrease) were significant predictors. For all\u2010cause mortality, baseline CAP was a protective predictor. When classified into subgroups based on LSM and CAP changes, the subgroup with both increased LSM and reduced CAP had the highest risks for CVEs (HR:5.3 [1.4\u201319.6]) and all\u2010cause mortality (HR: 3.4 [1.2\u20139.6]). The highest risk for LREs was observed in the subgroup with increased LSM without CAP reduction (HR: 3.5 [0.9\u201312.9]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VCTE parameters changes, LSM increase and CAP reduction, provide prognostic information for adverse liver, cardiovascular, and mortality outcomes in individuals with T2D and MASLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.16195","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T21:50:06Z","timestamp":1737064206000},"page":"2024-2034","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic value of changes in vibration\u2010controlled transient elastography parameters for liver, cardiovascular and mortality outcomes in individuals with type 2 diabetes and metabolic dysfunction\u2010associated steatotic liver disease: The Rio de Janeiro type 2 diabetes cohort"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9066-0405","authenticated-orcid":false,"given":"Nathalie C.","family":"Leite","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiane A.","family":"Villela\u2010Nogueira","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorrane V.","family":"Santos","sequence":"additional","affiliation":[{"name":"School of Medicine Universidade Federal do Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4909-0153","authenticated-orcid":false,"given":"Claudia R. L.","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6318-7077","authenticated-orcid":false,"given":"Gil F.","family":"Salles","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27368"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029349"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.025"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.1447"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.05.008"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.06.045"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.01.027"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15920"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000423"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17783"},{"key":"e_1_2_8_12_2","doi-asserted-by":"crossref","unstructured":"Epub 2023 Nov 15. 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