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Exp Clin Endocrinol Diabetes 2026; 134(01): 19-23
DOI: 10.1055/a-2765-6480
Article

Association of fibrosis index-4 (FIB-4) with chronic vascular complications of type 2 diabetes mellitus

Authors

  • Nikolaos Papanas 

    1   Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece (Ringgold ID: RIN112220)

  • Evanthia Gouveri

    1   Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece (Ringgold ID: RIN112220)

  • Theodoros Panou

    1   Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece (Ringgold ID: RIN112220)

  • Grigorios Trypsianis

    2   Department of Medical Statistics, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece (Ringgold ID: RIN112220)

  • Dimitrios Papazoglou

    1   Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece (Ringgold ID: RIN112220)
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Abstract

Fibrosis-Index-4 (FIB-4) is used with a cut-off of 1.3 to exclude severe fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of this study was to examine the potential association of FIB-4 with chronic vascular complications of type 2 diabetes mellitus (T2DM). Included were 550 adults (271 men) with T2DM, mean age of 67.88±11.46 years and median T2DM duration of 15 (9.75–22) years. FIB-4 was calculated and chronic vascular complications were recorded. Participants with FIB-4>1.3 were compared with those having FIB-4≤1.3. The former exhibited significantly more frequent peripheral neuropathy (corrected odds ratio [cOR]: 26.48, 95% confidence interval [CI]: 16.81–41.71, p<0.001), chronic kidney disease (cOR: 33.75, 95% CI: 19.55–58.28, p<0.001), retinopathy (cOR: 22.42, 95% CI: 14.22–35.34, p<0.001), stroke (cOR: 2.85, 95% CI: 1.56–5.21, p<0.001), coronary artery disease (cOR: 6.20, 95% CI: 4.25–9.04, p<0.001) and peripheral arterial disease (cOR: 4.60, 95%-CI: 2.62–8.07, p<0.001) than the latter. Peripheral neuropathy was staged as absent, mild and moderate-severe, based on the Neuropathy Disability-Score (NDS). FIB-4 score was associated with increased clinical severity of peripheral neuropathy (p<0.001).

Keywords

diabetes mellitus - FIB-4 - diabetic complications - microvascular disease - macrovascular disease


Publication History

Received: 22 September 2025

Accepted after revision: 04 December 2025

Accepted Manuscript online:
12 December 2025

Article published online:
11 February 2026

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