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The presence of T2DM increases the risk for liver fibrosis superimposed to other cardiometabolic risk factors in the GRIPonMASH screening cohort

The presence of T2DM increases the risk for liver fibrosis superimposed to other cardiometabolic risk factors in the GRIPonMASH screening cohort

Vivian D. de Jong1,2, Caterina Buranelli, Radan Bruha, Helena Cortez-Pinto, George V Dedoussis, Sven Francque, Adriaan G. Holleboom, Luca Miele, Christophe Moreno, Adrian Purcarea, Vlad Ratziu, Manuel Romero-Gómez, Jörn M. Schattenberg, Oscar H. Franco, Manuel Castro Cabezas2,3,4 on behalf of the GRIPonMASH consortium

1 UMCU | 2 Julius Clinical | 3 Franciscus Gasthuis & Vlietland | 4 Erasmus MC

Background: GRIPonMASH aims to screen 10,000 high-risk individuals recruited from primary care and outpatient clinics in 10 EU countries for advanced MASLD. We evaluated whether an increasing number of comorbidities worsens liver health.

Methods: Inclusion criteria are: T2DM, obesity (OB), metabolic syndrome (MetS) and/or arterial hypertension (AH), without a history of chronic liver disease. In this preliminary analysis, descriptive statistics (median [IQR] or percentage) are reported, stratified by each combination of aforementioned comorbidities (resulting in 15 groups). MASLD is defined as CAP >280 dB/m, hepatic fibrosis is assessed using liver stiffness measurements (LSM) by VCTE.

Results: The preliminary cohort comprised 2,421 participants. Of these, 34% had one condition, 35% had two, 19% had three, and 12% had all four conditions. The youngest group was OB-alone with 52 [18] years, whilst AH+OB+MetS was the oldest at 65 [12] years. GLP1 use was higher in every group with T2DM, ranging from 11% in T2DM-only to 39% with all four diagnoses. MASLD prevalence ranged from 25% (AH) to 68% (AH+OB+T2DM). The prevalence of significant liver fibrosis (LSM > 8 kPa) ranged from 3% (OB+MetS) to 19% (both AH+OB+T2DM and all four diagnoses). The highest prevalence of advanced fibrosis (LSM >12 kPa) was observed in: T2DM+MetS (4%), T2DM (5%), OB+T2DM and AH+OB+T2DM and all four (6%).

Conclusion: The prevalence of hepatic steatosis (25-68%) and significant fibrosis (3-19%) varies considerably across combinations of cardiometabolic conditions. No clear trend between an increasing number of comorbidities and the prevalence of MASLD was observed. However, having T2DM, particularly in combination with OB, appears to be the main driver of advanced fibrosis.

GRIPonMASH is supported by IHI JU, 101132946