Zhou, Xiao-Dong;
Chen, Qin-Fen;
Kim, Seung Up;
Cheuk-Fung Yip, Terry;
Petta, Salvatore;
Nakajima, Atsushi;
Tsochatzis, Emmanuel;
... Zheng, Ming-Hua; + view all
(2025)
Long-Term Glycemic Control and the Risk of Liver Stiffness Progression and Liver-Related Events in MASLD.
Clinical Gastroenterology and Hepatology
S1542-3565(25)00867.
10.1016/j.cgh.2025.10.003.
(In press).
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Abstract
BACKGROUND & AIMS: The long-term impact of type 2 diabetes (T2D) status and long-term glycemic control on disease progression and clinical outcomes in metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear. The study sought to assess the association of diabetes status and long-term glycemic control with liver stiffness progression or regression, and liver-related events (LREs) in MASLD. METHODS: We analyzed patients with MASLD from the VCTE-Prognosis cohort who underwent serial vibration-controlled transient elastography (VCTE) assessments and hemoglobin A1c (HbA1c) measurements. Long-term glycemic control was evaluated using the time-weighted average (TWA) HbA1c, which reflects both the magnitude and duration of glycemia. Patients were categorized as non-T2D, well-controlled T2D (TWA HbA1c<7%), or poorly controlled T2D (TWA HbA1c ≥7%). Liver stiffness progression, regression, and LREs were examined using Kaplan-Meier analyses and Cox proportional hazards models. RESULTS: Of 7543 patients with MASLD, 4090 had T2D (2045 well controlled, 2045 poorly controlled) and 3453 did not have T2D. Over a median follow-up of 4.1 years, patients with T2D had a higher risk of liver stiffness progression (hazard ratio [HR], 1.501, 95% confidence interval [CI]. 1.148-1.962; P = .003) and LREs (HR, 2.030; 95% CI, 1.241-3.320; P = .005), but not liver stiffness regression, compared with non-T2D patients. Among patients with T2D, poor glycemic control was associated with a higher risk of liver stiffness progression compared with good glycemic control (HR, 1.524; 95% CI, 1.182-1.965; P = .001). No differences were observed for liver stiffness regression (P = .957) or LREs (P = .625) with glycemic control. Findings were consistent across sensitivity analyses. CONCLUSIONS: T2D was independently associated with a higher risk of liver stiffness progression and LREs in MASLD. Good glycemic control was associated with slower liver stiffness progression, but not regression or LREs.
| Type: | Article |
|---|---|
| Title: | Long-Term Glycemic Control and the Risk of Liver Stiffness Progression and Liver-Related Events in MASLD |
| Location: | United States |
| DOI: | 10.1016/j.cgh.2025.10.003 |
| Publisher version: | https://doi.org/10.1016/j.cgh.2025.10.003 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Diabetes, Glycemic Control, Liver Stiffness Progression, Liver-Related Events, Metabolic Dysfunction–Associated Steatotic Liver Disease |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10217615 |
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