{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:24:19Z","timestamp":1792441459005,"version":"4.5.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the influence of finerenone, a novel nonsteroidal selective mineralocorticoid receptor antagonist (nsMRA), on the hepatic fibrosis indicator FIB-4, as well as its safety profile in hospitalized patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) managed in the endocrinology department.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A single-center, retrospective cohort design was employed, enrolling 138 consecutive hospitalized patients who initiated finerenone therapy for the first time in our endocrinology department between June 2023 and December 2024. Baseline data and subsequent outpatient follow-up records were extracted to calculate the FIB-4 and assess changes in hepatic and renal function, serum potassium levels, and adverse events during treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the enrolled cohort, 119 patients (85.6%) had complete baseline laboratory profiles, with a mean age of 63.1 years and 58% male. Baseline FIB-4 median 1.15. Among 52 patients (43%) who completed follow-up, the median follow-up duration was 6 months (range 1\u201316 months). The median follow-up FIB-4 declined to 1.10, representing an absolute reduction of 0.05. Patients with follow-up exceeding 12 months follow-up showed a further reduction to 0.96. Importantly, no cases of treatment discontinuation due to hyperkalemia were documented during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In real-world clinical practice, finerenone in T2DM patients with CKD trended to lower FIB-4 values, especially with longer use. However, no statistical significance and study limitations preclude definitive conclusions on its antifibrotic activity. These findings are hypothesis-generating and need confirmation in large, prospective, long-term studies with robust endpoints and proper controls.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1745102","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T05:26:06Z","timestamp":1770701166000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A retrospective cohort study on the impact of finerenone on the hepatic fibrosis indicator FIB-4"],"prefix":"10.3389","volume":"17","author":[{"given":"Bo","family":"An","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wencheng","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijun","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingda","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huixian","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease: meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"Younossi","year":"2016","journal-title":"J Hepatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"494","DOI":"10.3760\/cma.j.cn501113-20240327-00163","article-title":"Guidelines for the prevention and treatment of metabolic-associated (nonalcoholic) fatty liver disease (2024 edition)","volume":"27","author":"JG","year":"2024","journal-title":"J Pract Hepatol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/bph.15853","article-title":"Chronic liver diseases: from development to novel pharmacological therapies","volume":"180","author":"Borrello","year":"2023","journal-title":"IUPHAR Rev 37. Br J Pharmacol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1618","article-title":"Nonalcoholic fatty liver disease screening in patients with type 2 diabetes mellitus in the primary care setting","volume":"5","author":"Vieira Barbosa","year":"2020","journal-title":"Hepatol Commun"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10100842","article-title":"Appropriate timing for evaluating liver fibrosis using the hepatic fibrosis indicator FIB-4 index in patients with nonalcoholic fatty liver disease in Japan","volume":"10","author":"Seko","year":"2020","journal-title":"Diagnostics (Basel)"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1172178","article-title":"Association between hepatic fibrosis indicator FIB-4 index, all-cause mortality, cardiovascular mortality, and cardiovascular disease risk among individuals with type 2 diabetes mellitus: NHANES 1999-2008","volume":"10","author":"Guan","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/bph.15784","article-title":"Role of mineralocorticoid receptor (MR) in nonalcoholic fatty liver disease","volume":"179","author":"Schreier","year":"2022","journal-title":"Br J Pharmacol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13081792","article-title":"The role of aldosterone and mineralocorticoid receptor (MR) in metabolic dysfunction-associated steatotic liver disease","volume":"13","author":"Barigou","year":"2025","journal-title":"Biomedicines"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.563434","article-title":"Mineralocorticoid receptor deficiency in myeloid cells reduces liver steatosis by impairing activation of CD8^+ T cells in a mouse model of nonalcoholic steatohepatitis","volume":"11","author":"Mu\u00f1oz-Durango","year":"2020","journal-title":"Front Immunol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)30935-4","article-title":"Hepatoprotective effects of the selective mineralocorticoid receptor antagonist eplerenone against carbon tetrachloride-induced liver injury in rats","volume":"11","author":"Taye","year":"2012","journal-title":"Ann Hepatol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.12092\/j.issn.1009-2501.2022.04.016","article-title":"New advances in the clinical application of finerenone","volume":"27","author":"Cheng","year":"2022","journal-title":"Chin J Clin Pharmacol Ther"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2110956","article-title":"Cardiovascular events associated with finerenone in patients with chronic kidney disease and type 2 diabetes mellitus","volume":"385","author":"Pitt","year":"2021","journal-title":"N Engl J Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of finerenone on chronic kidney disease outcomes in patients with type 2 diabetes mellitus","volume":"383","author":"Bakris","year":"2020","journal-title":"N Engl J Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1111\/dom.15305","article-title":"Efficacy of finerenone in patients with type 2 diabetes mellitus, chronic kidney disease, and altered markers of liver steatosis and fibrosis: a FIDELITY subgroup analysis","volume":"26","author":"Perakakis","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"B15","doi-asserted-by":"publisher","first-page":"83","DOI":"10.2220\/biomedres.46.83","article-title":"Finerenone alleviates high glucose-induced fibrosis in HK-2 cells by inhibiting epithelial\u2013mesenchymal transition via TGF-\u03b21\/Smads signaling pathway","volume":"46","author":"Wang","year":"2025","journal-title":"BioMed Res"},{"key":"B16","volume-title":"Aldosterone induces hepatic stellate cells activation and liver fibrosis through Cav-1 dependent pathway, 28 August 2023, PREPRINT (Version 1) available at Research Square","author":"Li","year":""},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21669","article-title":"FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection, in comparison with liver biopsy and FibroTest","volume":"46","author":"Vallet-Pichard","year":"2007","journal-title":"Hepatology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"9443","DOI":"10.1038\/s41598-023-36668-2","article-title":"Improvement in on-treatment FIB-4 during antiviral therapy is associated with lower hepatocellular carcinoma risk in cirrhotic patients with hepatitis B","volume":"13","author":"Oh","year":"2023","journal-title":"Sci Rep"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.70066","article-title":"Liver function effects of SGLT2 inhibitor and GLP-1 receptor agonist combination treatment in patients with type 2 diabetes (post hoc analysis of RECAP study)","volume":"16","author":"Tsuriya","year":"2025","journal-title":"J Diabetes Investig"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1745102\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T05:26:10Z","timestamp":1770701170000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1745102\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":19,"alternative-id":["10.3389\/fendo.2026.1745102"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1745102","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]},"article-number":"1745102"}}