1349-P: Rates of Fibrosis-4 Index Availability among Patients with Newly Diagnosed Type 2 Diabetes in a Nationwide U.S. Cohort

by sugaradmin



Introduction and Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in people with type 2 diabetes (T2D). MASLD screening is now recommended through calculation of the fibrosis-4 index (FIB4), derived from age, platelet count, AST, and ALT. We evaluated the rate at which these markers were obtained within 2 years for patients with new T2D within the Epic Cosmos Data Network.Methods: Epic Cosmos is a dataset created in collaboration with health systems representing more than 292 million patients. We included United States patients with a first problem list entry of T2D between January 1, 2017 to December 31, 2022 and calculated the percentage of patients with an AST, ALT, and platelet count obtained within 2 years of this entry. We stratified our analyses by year, age, body mass index (BMI) at the time of diagnosis, race, and ethnicity.Results: Between 2017 and 2022, 56.1% of patients with new T2D (n=2,691,796) obtained FIB4 markers within 2 years. Rates increased from 54.2% in 2017 to 59.2% in 2022. Among patients with available demographic information, there was low variation across age groups, from 54.3% for ages 18 to 30 years to 54.9% for 70+ years. Asians were least likely to have FIB4 screening labs by 2 years (50.0%), followed by people of White (51.8%), Native American (53.2%), and Black (54.3%) ancestry. Rates were 52.5% in patients with Hispanic/Latino ethnicity and 52.1% in those without. Rates were 65.2% for patients with a BMI of <18.5, 59.1% for 18.5 to 25, 57.0% for 25 to 30, 56.2% for 30 to 40, 57.1% for 40 to 50, and 59.0% for over 50. All results were statistically significant (p<0.0001) due to the large numbers.Conclusion: A substantial portion of patients with new T2D are not getting the recommended screening for MASLD within 2 years of diagnosis, although rates are increasing with time. In our analysis, Asians and patients with elevated BMI were less likely to have laboratory values available for calculating the FIB4 index.

Disclosure

J.Q. Core: None. M.J. O’Connor: None.



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