P-3 FACTORS ASSOCIATED WITH AN IMPROVEMENT IN SEQUENTIAL LIVER STIFFNESS MEASURES BY TRANSIENT ELASTOGRAPHY IN MASLD PATIENTS WITH PREDIABETES AND TYPE 2 DIABETES.

Conflict of interest

No

Introduction and Objectives

There is increasing evidence that a ≥20% decrease in sequential liver stiffness measurements (ΔLSM) by transient elastography (TE) is associated with a lower risk of long-term liver-related outcomes and mortality in patients with MASLD. Objective: We aimed to evaluate factors associated with ≥20% decrease in ΔLSM in MASLD patients with prediabetes (Pre-DM) and type 2 diabetes (T2DM).

Patients / Materials and Methods

MASLD adults with PreDM or T2DM with two consecutive reliable LSMs by transient TE (Fibroscan Touch 502) were included. Clinical, biochemical and elastography data were collected at baseline and follow-up. PNPLA3 (rs738409 C>G) genotypes were determined. A multivariate logistic regression analysis was performed to evaluate the variables independently associated with ≥20% decrease in ΔLSM. All data were analyzed using the statistical package SPSS (vs.24.0,IBM), a p-value < 0.05 was regarded as significant.

Results and Discussion

294 patients were included (70% female, 60 ± 10 y, 63% with BMI ≥ 30 kg/m2): 14% had PreDM and 86% T2DM. Genotyping of PNPLA3 was identified as CC in 46% and CG+GG in 54%. At the first TE, 10% had LSM > 15kPa [median 7.0 kPa (5.1-10.1)]. Overall, 31% experienced a ≥20% decrease in ΔLSM on a 38 (26-52) months interval.

On logistic multivariate regression, the variables independently associated with a ≥20% decrease in ΔLSM were the genotype CC of PNPLA3 (OR 1.71/ 95%CI 1.03-2.85; p=0.038) and final glycated hemoglobin ≤7% (OR 1.75/ 95%CI 1.04-2.94; p=0.034) . Statin use (OR 1.78/ 95%CI 0.99-3.18; p=0.05) had a borderline statistical significance.

Conclusions

A clinically significant improvement in LSM is associated with a better glycemic control and the presence of wild-type PNPLA3CC in MASLD patients with PreDM or T2DM. Future prospective studies are needed to determine whether genetic predisposition and factors of clinical importance may confer a reduction in the risk of liver-related outcomes in these high-risk populations.