Prognostic impact of liver fibrosis and steatosis by transient elastography for cardiovascular and mortality outcomes in individuals with nonalcoholic fatty liver disease and type 2 diabetes: the Rio de Janeiro Cohort Study

Cardoso, Claudia R. L.; Villela-Nogueira, Cristiane A.; Leite, Nathalie C.; Salles, Gil F.

doi:10.1186/s12933-021-01388-2

Cardiovascular Diabetology

Table 2 Risks of adverse outcomes associated with higher liver stiffness measurement (LSM, indicating fibrosis) and controlled attenuation parameter (CAP, indicating liver steatosis) on hepatic transient elastography (TE) in 400 patients with type 2 diabetes and NAFLD

From: Prognostic impact of liver fibrosis and steatosis by transient elastography for cardiovascular and mortality outcomes in individuals with nonalcoholic fatty liver disease and type 2 diabetes: the Rio de Janeiro Cohort Study

Outcomes	Model 1^a		Model 2^b
TE parameters	HR (95% CI)	p-value	HR (95% CI)	p-value
Total Cardiovascular Events (n = 69)
LSM (1 kPa increase)	1.04 (1.00-1.08)	0.037	1.05 (1.01–1.08)	0.007
CAP (10 dB/m increase)	0.94 (0.90–0.99)	0.022	0.93 (0.89–0.98)	0.008
LSM > 9.6 kPa	1.99 (1.09–3.62)	0.024	2.66 (1.41–5.02)	0.002
CAP > 296 dB/m	0.53 (0.31–0.92)	0.023	0.44 (0.25–0.78)	0.005
CAP > 330 dB/m	0.42 (0.19–0.93)	0.032	0.36 (0.16–0.80)	0.012
Major Adverse Cardiovascular Events (n = 50)
LSM (1 kPa increase)	1.05 (1.00–1.09)	0.041	1.05 (1.01–1.09)	0.011
CAP (10 dB/m increase)	0.92 (0.87–0.98)	0.006	0.91 (0.86–0.97)	0.002
LSM > 9.6 kPa	2.26 (1.14–4.49)	0.020	3.03 (1.47–6.26)	0.003
CAP > 296 dB/m	0.45 (0.24–0.87)	0.018	0.37 (0.19–0.73)	0.004
CAP > 330 dB/m	0.34 (0.13–0.91)	0.031	0.29 (0.11–0.78)	0.014
All-cause Mortality (n = 85)
LSM (1 kPa increase)	1.04 (1.01–1.07)	0.012	1.04 (1.01–1.07)	0.004
CAP (10 dB/m increase)	0.93 (0.89–0.97)	0.002	0.92 (0.88–0.97)	0.001
LSM > 9.6 kPa	1.58 (0.87–2.87)	0.13	1.70 (0.90–3.21)	0.10
CAP > 296 dB/m	0.53 (0.31–0.89)	0.016	0.50 (0.29–0.85)	0.010
CAP > 330 dB/m	0.53 (0.26–1.07)	0.077	0.50 (0.25–1.02)	0.057
Cardiovascular Mortality (n = 40)
LSM (1 kPa increase)	1.02 (0.96–1.08)	0.47	1.04 (0.99–1.10)	0.14
CAP (10 dB/m increase)	0.91 (0.85–0.97)	0.006	0.90 (0.84–0.97)	0.003
LSM > 9.6 kPa	1.68 (0.73–3.84)	0.22	2.46 (1.02–5.95)	0.045
CAP > 296 dB/m	0.38 (0.18–0.83)	0.015	0.32 (0.14–0.71)	0.005
CAP > 330 dB/m	0.35 (0.12–1.04)	0.058	0.30 (0.10–0.92)	0.035
Non-Cardiovascular Mortality (n = 45)
LSM (1 kPa increase)	1.05 (1.01–1.09)	0.010	1.05 (1.01–1.09)	0.014
CAP (10 dB/m increase)	0.94 (0.88–1.01)	0.073	0.94 (0.88-1.00)	0.066
LSM > 9.6 kPa	1.34 (0.55–3.24)	0.52	1.09 (0.41–2.91)	0.86
CAP > 296 dB/m	0.68 (0.33–1.39)	0.29	0.68 (0.33–1.39)	0.29
CAP > 330 dB/m	0.76 (0.29–1.98)	0.58	0.76 (0.30–1.98)	0.58

Values are hazard ratios (HR) with 95% confidence intervals
TE transient elastography, LSM liver stiffness measurement, CAP controlled attenuation parameter
^aModel 1 was adjusted for age, sex, diabetes duration, BMI, smoking, arterial hypertension, presence of atherosclerotic cardiovascular diseases and microvascular complications at baseline, serum HbA1c, LDL- and HDL-cholesterol, and use of insulin, statins and aspirin
^bModel 2 was further concomitantly adjusted for both LSM and CAP

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