6959 Variation of FIB-4 Classification In A 5-Year Follow-Up Cohort of Patients With Type 2 Diabetes Mellitus Managed By A Multi-Disciplinary Team In A Hospital In Northeastern Mexico
Authors: Ibarguengoitia Maria Elena Romero , Morales-Rodríguez Devany Paola , González-Cantú Arnulfo , Garza-Silva Arnulfo , Rivera-Cavazos Andrea , Fernández-Chau Iván Francisco , Cepeda-Medina Andrea Belinda 
Published: October 2024

Abstract
Disclosure: M. Romero Ibarguengoitia: None. D.P. Morales-Rodríguez: None. A. González-Cantú: None. A. Garza-Silva: None. A. Rivera-Cavazos: None. I. Fernández-Chau: None. A. Cepeda-Medina: None.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common pathology associated to type 2 diabetes mellitus (T2DM), however the change in its classification over time is unknown in patients with T2DM managed by a multidisciplinary team in a population of Northern Mexico. Therefore, we analyzed the change in the FIB-4 classification for MASLD before and during 3 years of SARS-CoV-2 pandemic. We conducted a retrospective observational cohort study on a population of steelworkers with T2DM from a hospital in Northeastern Mexico from 2018 to 2022 treated by a multidisciplinary team. This team was comprised by an internist or geriatrician based on patient’s age, an endocrinologist, a nutritionist, and other specialties related to T2DM. We analyzed levels of HbA1C, fasting serum glucose (FSG), attendance to various specialties consultations, trends in medication usage and changes in the classification of FIB-4 scale. A total of 999 subjects were studied, with 516 (51.7%) being male, average age (SD) of 60.1 (12.7) years. There was a significant difference in the proportion of patients with controlled HbA1C levels, being 55.5% in 2018 and rising to 64.3% in 2020 and to 70.7% in 2022 (p&lt;0.001). An increase in the proportion of patients in control based on FSG was observed, from 13.8% in 2018 to 54.8% in 2020 and 56.1% in 2022 (p&lt;0.001). Throughout the follow-up period, all patients had at least one annual consultation with an internist or geriatrician according to their age group. Additionally, there was an increase in assistance to endocrinology consultations from 8.5% in 2018 to 9.9% in 2020 and 12.1% in 2022 (p&lt;0.001). There was a rise in the prescription of oral hypoglycemic agents in general from 4.9% in 2018 to 14.2% in 2020, with an increase of GLP-1 analogs from 3.3% in 2018 to 9.3% in 2020 (p&lt;0.001). Regarding the categorization by FIB-4, in 2018, a proportion of 64.8% of patients were observed in the F0-F1 category, 30.2% in the F2 category, and 4.8% in the F3-F4 category (p&lt;0.001). These levels remained similar for 2020, with 62.6% in the F0-F1 category, 32.4% in the F2 category, and 4.9% in the F3-F4 category (p&lt;0.001). In 2022, there is an increase in the proportion of patients in the F0-F1 category, reaching 71.8% of our population, along with a decrease in those classified as F2 to 20.9%, and a slight increase in the proportion of patients in the F3-F4 category to 7.2% (p&lt;0.001). MASLD is a condition that occurs frequently in our population; however, it is possible to stabilize and even decrease its classification through a multidisciplinary and specialized team capable of treating T2DM effectively by optimizing its management with GLP-1 prescription and a prompt referral to endocrinology consultation with the aim of providing a good quality of life for the patients.
Presentation: 6/2/2024