Abstract / Summary
BackgroundIn patients with type 2 diabetes mellitus (T2DM), the Fibrosis-4 (FIB-4) index can be a simple indicator of vascular risk.This study aimed to assess the association between the FIB-4 index and subclinical vascular disease in patients with T2DM using mean carotid intima-media thickness (CIMT) as the primary outcome and maximum CIMT, carotid plaque, and brachial-ankle pulse wave velocity (baPWV) as secondary vascular outcomes. MethodologyThis analytical cross-sectional study was conducted in a hospital setting at Sheikh Zayed Medical College and Hospital, Pakistan, between April 2024 and March 2026.A total of 250 individuals with T2DM were consecutively recruited.FIB-4 was computed using age, aspartate aminotransferase, alanine aminotransferase, and platelet count.Maximum CIMT, carotid plaque, and baPWV were secondary outcomes to mean CIMT.Both a multivariable regression analysis and a correlation analysis were performed. ResultsThe mean age of the 250 participants was 58.7 ± 10.4 years, and 139 (55.6%) were men.The FIB-4 index was 1.71 ± 0.92 on average.Carotid plaque was present in 71 (28.4%) participants, and the mean CIMT, maximum CIMT, and baPWV were 0.78 ± 0.15 mm, 1.02 ± 0.31 mm, and 1,742 ± 348 cm/s, respectively.Across the low, intermediate, and high FIB-4 groups, mean CIMT increased considerably (0.72 ± 0.11, 0.81 ± 0.14, and 0.91 ± 0.17 mm, respectively; p < 0.001).Carotid plaque was present in 20 (17.9%), 41 (34.5%), and 10 (52.6%) participants in the low, intermediate, and high FIB-4 groups, respectively (p = 0.002).FIB-4 had a positive correlation with baPWV (ρ = 0.29; p < 0.001), mean CIMT (ρ = 0.36; p < 0.001), and maximal CIMT (ρ = 0.31; p < 0.001).Higher FIB-4 remained independently associated with mean CIMT (β = 0.041; p < 0.001), maximal CIMT (β = 0.073; p = 0.001), baPWV (β = 96.4;p = 0.002), and carotid plaque (odds ratio = 1.48; p = 0.002) after controlling for covariates. ConclusionsIn individuals with T2DM, higher FIB-4 was significantly linked to structural and functional indicators of subclinical vascular disease, indicating its possible use as a straightforward risk-enrichment marker for cardiovascular evaluation.