{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T23:39:35Z","timestamp":1783381175502,"version":"3.54.6"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Screening for liver fibrosis holds significant importance in patients with type 2 diabetes mellitus (T2DM) due to their elevated risk of advanced hepatic fibrosis. However, it is recognized that the diagnostic performance of the Fibrosis\u20104 (FIB\u20104) index is relatively low in T2DM patients. Our study aims to explore the potential and limitations of utilizing FIB\u20104 as a screening tool in patients with T2DM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective biopsy cohort of 1906 patients with biopsy\u2010proven metabolic dysfunction\u2010associated steatotic liver disease from South Korea, Japan, and Taiwan. Diagnostic performance according to T2DM was again compared after propensity score matching on age, sex, and body mass index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with T2DM were significantly older than those without. The area under the receiver operating characteristic curve (AUROC) of FIB\u20104 for ruling out advanced fibrosis in non\u2010T2DM patients was significantly higher than that of T2DM (0.821 vs. 0.761, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.044). However, the AUROCs of FIB\u20104 according to the same age groups showed no significant difference between patients with T2DM and without (all <jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.05). In the middle\u2010aged group, the sensitivity of FIB\u20104 for ruling out advanced hepatic fibrosis was 77.1% for T2DM and did not differ with that of non\u2010T2DM patients (73.0%) (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.093). After propensity score matching of age, there was no statistically significant difference in the AUROCs of the T2DM and non\u2010T2DM groups (0.860 vs. 0.761, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.142).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the diagnostic performance of FIB\u20104 was found to be suboptimal in patients with T2DM, its limited use in individuals under 65\u00a0years of age with T2DM still holds value as a screening tool.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.14152","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T13:15:24Z","timestamp":1734614124000},"page":"505-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Limited use of FIB\u20104 index in patients under 65\u00a0years of age with type 2 diabetes mellitus"],"prefix":"10.1111","volume":"55","author":[{"given":"Mimi","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiology Hanyang University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen L.","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hanyang University College of Medicine  Seoul Korea"},{"name":"Hanyang Institute of Bioscience and Biotechnology Hanyang University  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiyul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Myoungji Hospital Hanyang University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2594-0854","authenticated-orcid":false,"given":"Takanori","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0938-631X","authenticated-orcid":false,"given":"Masatoshi","family":"Ishigami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ae Jung","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Information Statistics Andong National University  Andong Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chul\u2010Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology Hanyang University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo\u2010Kyeong","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Radiology Hanyang University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye\u2010Lin","family":"Kim","sequence":"additional","affiliation":[{"name":"College of Pharmacy Sahmyook University  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taeang","family":"Arai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3374-7111","authenticated-orcid":false,"given":"Masanori","family":"Atsukawa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2341-5199","authenticated-orcid":false,"given":"Miwa","family":"Kawanaka","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine Kawasaki Medical School General Medical Center  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Ogaki Municipal Hospital  Ogaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8145-1900","authenticated-orcid":false,"given":"Ming\u2010Lung","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2875-6139","authenticated-orcid":false,"given":"Dae Won","family":"Jun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hanyang University College of Medicine  Seoul Korea"},{"name":"Hanyang Institute of Bioscience and Biotechnology Hanyang University  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindie H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Stanford University Medical Center  Palo Alto California USA"},{"name":"Department of Epidemiology and Population Health Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2468\u20101253(22)00165\u20100"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15259"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.08.018"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2016.147"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.11.010"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14828"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.01.010"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2022.0096"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.02.059"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.05.015"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/mcg.0000000000001339"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19\u20101071"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2020.01.001"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13739"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22\u20100556"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592\u2010019\u201001467\u20107"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535\u2010018\u20101474\u2010y"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.453"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.5812\/hepatmon.15167"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1024836"}],"container-title":["Hepatology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hepr.14152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T19:02:01Z","timestamp":1743793321000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hepr.14152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,19]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/hepr.14152"],"URL":"https:\/\/doi.org\/10.1111\/hepr.14152","archive":["Portico"],"relation":{},"ISSN":["1386-6346","1872-034X"],"issn-type":[{"value":"1386-6346","type":"print"},{"value":"1872-034X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,19]]},"assertion":[{"value":"2024-08-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}