AUTHOR=Grancini Valeria , Cogliati Irene , Alicandro Gianfranco , Gaglio Alessia , Gatti Stefano , Donato Maria Francesca , Orsi Emanuela , Resi Veronica 

TITLE=Assessment of hepatic fibrosis with non-invasive indices in subjects with diabetes before and after liver transplantation

JOURNAL=Frontiers in Endocrinology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1359960

DOI=10.3389/fendo.2024.1359960

ISSN=1664-2392

ABSTRACT=<sec><title>Introduction</title><p>One of the most common complications of cirrhosis is diabetes, which prevalence is strictly related to severity of hepatopathy. Actually, there are no data on the persistence of post-transplant glucose abnormalities and on a potential impact of diabetes on development of fibrosis in the transplanted liver. To this aim, we evaluated liver fibrosis in cirrhotic subjects before and after being transplanted.</p></sec><sec><title>Methods</title><p>The study included 111 individuals who had liver transplantation. The assessment was performed before and two years after surgery to investigate a potential impact of the persistence of diabetes on developing <italic>de novo</italic> fibrosis in the transplanted liver. The degree of fibrosis was assessed using the Fibrosis Index Based on 4 Factors (FIB-4) and the Aspartate to Platelet Ratio Index (APRI).</p></sec><sec><title>Results</title><p>At pre-transplant evaluation, 63 out of 111 (56.8%) subjects were diabetic. Diabetic subjects had higher FIB-4 (Geometric mean, 95% confidence interval: 9.74, 8.32-11.41 <italic>vs</italic> 5.93, 4.71-7.46, <italic>P</italic>&lt;0.001) and APRI (2.04, 1.69-2.47 <italic>vs</italic> 1.18, 0.90-1.55, <italic>P</italic>&lt;0.001) compared to non-diabetic subjects. Two years after transplantation, 39 out of 111 (35.1%) subjects remained with diabetes and continued to show significantly higher FIB-4 (3.14, 2.57-3.82 <italic>vs</italic> 1.87, 1.55-2.27, <italic>P</italic>&lt;0.001) and APRI (0.52, 0.39-0.69 <italic>vs</italic> 0.26, 0.21-0.32, <italic>P</italic>&lt;0.001) compared to subjects without diabetes.</p></sec><sec><title>Discussion</title><p>Thus, persistence of diabetes after surgery is a possible risk factor for an evolution to fibrosis in the transplanted liver, potentially leading to worsened long-term outcomes in this population.</p></sec>