{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T08:08:56Z","timestamp":1785658136825,"version":"3.56.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,10,31]],"date-time":"2019-10-31T00:00:00Z","timestamp":1572480000000},"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":["Liver International"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Non\u2010alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are closely associated, and liver fibrosis has been related to macrovascular complications. We examined whether liver fibrosis, diagnosed by FibroScan<jats:sup>\u00ae<\/jats:sup>, correlates with chronic vascular complications in a cohort of T2DM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We recruited 394 outpatients with T2DM attending five Italian diabetes centres who underwent liver ultrasonography (US), FibroScan<jats:sup>\u00ae<\/jats:sup> and extensive evaluation of macrovascular and microvascular diabetic complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Steatosis by US was present in 89%. Almost all patients (96%) were on hypoglycaemic drugs, 58% had at least one chronic vascular complication, 19% a macrovascular complication (prior myocardial infarction and\/or ischaemic stroke) and 33% a microvascular one (26% chronic kidney disease [CKD]; 16% retinopathy; 6% neuropathy). In all, 171 (72%) patients had CAP\u00a0\u2265\u00a0248dB\/m (ie hepatic steatosis), whereas 83 (21%) patients had LSM\u00a0\u2265\u00a07.0\/6.2\u00a0kPa (M\/XL probes) (significant liver fibrosis). CAP was not associated with any macro\/microvascular complications, whereas LSM\u00a0\u2265\u00a07.0\/6.2\u00a0kPa was independently associated with prior cardiovascular disease (adjusted OR 3.3, 95%CI 1.2\u20108.8; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02) and presence of microvascular complications (adjusted OR 4.2, 95%CI 1.5\u201011.4; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.005), mainly CKD (adjusted OR 3.6, 95%CI 1.3\u201010.1; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01) and retinopathy (adjusted OR 3.7, CI 95% 1.2\u201011.9; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02). Neither diabetes duration nor haemoglobin A1c differed according to CAP or LSM values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Significant fibrosis, detected by FibroScan<jats:sup>\u00ae<\/jats:sup>, is independently associated with increased prevalence of macrovascular and microvascular complications, thus opening a new scenario in the use of this tool for a comprehensive evaluation of hepatic and vascular complications in patients with T2DM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14274","type":"journal-article","created":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T06:14:48Z","timestamp":1571120088000},"page":"347-354","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":83,"title":["Liver fibrosis by FibroScan<sup>\u00ae<\/sup> independently of established cardiovascular risk parameters associates with macrovascular and microvascular complications in patients with type 2 diabetes"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-927X","authenticated-orcid":false,"given":"Rosa","family":"Lombardi","sequence":"first","affiliation":[{"name":"Department of Pathophysiology and Transplantation Ca' Granda IRCCS Foundation Policlinico Hospital University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5466-8151","authenticated-orcid":false,"given":"Lorena","family":"Airaghi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation Ca' Granda IRCCS Foundation Policlinico Hospital University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-3900","authenticated-orcid":false,"given":"Giovanni","family":"Targher","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism Department of Medicine University Hospital of Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6424-7841","authenticated-orcid":false,"given":"Gaetano","family":"Serviddio","sequence":"additional","affiliation":[{"name":"Centro C.U.R.E Department of Medical and Surgical Sciences University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Maffi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation Ca' Granda IRCCS Foundation Policlinico Hospital University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7271-6329","authenticated-orcid":false,"given":"Alessandro","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism Department of Medicine University Hospital of Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Maffeis","sequence":"additional","affiliation":[{"name":"Pediatric Diabetes and Metabolic Disorders Unit Department of Surgical Sciences, Dentistry, and Pediatrics, and Gynaecology University Hospital of Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Colecchia","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"Villani","sequence":"additional","affiliation":[{"name":"Centro C.U.R.E Department of Medical and Surgical Sciences University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University of Campania Luigi Vanvitelli Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Orsi","sequence":"additional","affiliation":[{"name":"Department of Medical Science, Endocrinology and Diabetes Unit Ca' Granda IRCCS Foundation Policlinico Hospital University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Pisano","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation Ca' Granda IRCCS Foundation Policlinico Hospital University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8453-4912","authenticated-orcid":false,"given":"Luigi E.","family":"Adinolfi","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University of Campania Luigi Vanvitelli Naples 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