{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T09:55:16Z","timestamp":1781517316182,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004271","name":"Sapienza Universit\u00e0 di Roma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004271","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021856","name":"Ministero dell'Universit\u00e0 e della Ricerca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021856","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Metabolic dysfunction\u2010associated steatotic liver disease (MASLD) frequently coexists with type 2 diabetes (T2D) and increases cardiovascular disease (CVD) risk, with hepatic fibrosis being the main determinant of mortality. Existing non\u2010invasive fibrosis scores often include age and may be less informative in early\u2010stage disease or long\u2010term follow\u2010up. This study investigated the association between the Fibrotic NASH Index (FNI), an age\u2010independent marker and long\u2010term all\u2010cause mortality in T2D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective longitudinal study in a cohort of 174 individuals with T2D (baseline age 67.6\u2009\u00b1\u200911.4\u2009years; BMI 29.3\u2009\u00b1\u20095.2\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; HbA1c 7.1%\u2009\u00b1\u20091.7%) enrolled in 2000\u20132001. Complete mortality data at 20\u2009years were available for all the study participants. Hepatic steatosis was assessed by ultrasound, and fibrosis risk was estimated using FNI; FIB\u20104 and APRI were also calculated. Baseline metabolic, biochemical and clinical data were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, steatosis was present in 78% and high fibrosis risk in 44% of participants. After 20\u2009years, mortality reached 39.7%. The FNI\u2010defined fibrosis risk was significantly associated with the vital status at 20\u2009years in both univariate and multivariable models adjusted for age, sex, BMI, lipids, renal function, steatosis, diabetes' duration and CVD history (OR 11.75; 95% CI: 2.11\u201365.50;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), whereas neither FIB4 nor APRI retained a significant association after multivariable adjustment (FIB\u20104: OR 1.50; 95% CI: 0.52\u20134.37;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.45; APRI: OR 1.49; 95% CI: 0.29\u20137.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.63).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FNI\u2010defined liver fibrosis risk is independently associated with long\u2010term mortality in individuals with T2D. Incorporating non\u2010invasive, age\u2010independent fibrosis assessment may help improve early risk stratification and guide personalised management in dysmetabolic populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70676","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:01:42Z","timestamp":1778738502000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fibrotic\n                    <scp>NASH<\/scp>\n                    Index (\n                    <scp>FNI<\/scp>\n                    ) Is Associated with Long\u2010Term Mortality in Individuals with Type 2 Diabetes and\n                    <scp>MASLD<\/scp>"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0530-8568","authenticated-orcid":false,"given":"Ilaria","family":"Barchetta","sequence":"first","affiliation":[{"name":"Department of Experimental Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia Agata","family":"Cimini","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Dule","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Passarella","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Oldani","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Neve","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Cirelli","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Alfano","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Gisella","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Sapienza University  Rome 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