{
  "abstract": "Background\n\nCardiovascular disease is a major extrahepatic outcome in type 2 diabetes mellitus (T2DM) and metabolic fatty liver disease, but prospective data integrating transient elastography and the fibrosis-4 index (FIB-4) with observed cardiovascular events remain limited in Southeast Asia.Methods\n\nWe conducted a prospective cohort study of adults with T2DM consecutively recruited at a Vietnamese tertiary hospital from June 2023 through January 2025 and followed for up to 24 months. Hepatic steatosis and liver stiffness were assessed by FibroScan©, and metabolic dysfunction-associated fatty liver disease (MAFLD) was defined using the Asian Pacific Association for the Study of the Liver framework. Expanded major adverse cardiovascular events (MACE) were the principal time-to-event outcome. Sparse-event associations were estimated with Firth-penalized Cox regression.Results\n\nOf 452 patients screened, 301 consented and 284 entered the baseline cohort; 280 contributed follow-up. At baseline, MAFLD was present in 72.5% and significant liver fibrosis (liver stiffness measurement ≥7.0 kPa) in 23.9%. During 544.92 person-years, 11 expanded MACE and 5 conventional MACE occurred, corresponding to incidence rates of 20.19 (95% CI 10.08-36.12) and 9.18 (95% CI 2.98-21.41) per 1,000 person-years. In the main Firth model adjusted for age and MAFLD, each increase of 1 interquartile range (IQR; 0.696 units) in FIB-4 was associated with expanded MACE (adjusted hazard ratio 1.56, 95% CI 1.09-1.99; p = 0.022), whereas MAFLD was not statistically significant (adjusted hazard ratio 3.51, 95% CI 0.79-33.09; p = 0.105); the point estimate was above unity but imprecise because of the limited number of events.Conclusion\n\nHigher FIB-4 was associated with short-term cardiovascular events in adults with T2DM. Given the small number of events, these findings require confirmation in larger multicenter cohorts.",
  "abstract_shown": true,
  "affiliations": [
    "Internal Medicine Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam.",
    "Nhan Dan Gia Dinh Hospital, Ho Chi Minh, Vietnam."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Quoc Bao Vu"
    },
    {
      "affs": [
        1
      ],
      "name": "Hong Minh Cong Vo"
    },
    {
      "affs": [
        1
      ],
      "name": "Xuan Linh Tran"
    },
    {
      "affs": [
        0
      ],
      "name": "Tuan Vu Nguyen"
    },
    {
      "affs": [
        0
      ],
      "name": "Thi Khanh Tuong Tran"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9b0rkj4wd7kdb.bib",
  "cited_by": 0,
  "doi": "10.3389/fgstr.2026.1973311",
  "fulltext_url": "https://europepmc.org/articles/PMC13683220",
  "id": "9b0rkj4wd7kdb",
  "issns": [
    "2813-1169"
  ],
  "landing_url": "https://europepmc.org/article/MED/42908838",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Liver Disease Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7220853651",
  "pdf_url": "https://europepmc.org/articles/PMC13683220?pdf=render",
  "pmcid": "PMC13683220",
  "pmid": "42908838",
  "published": "2026-10-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9b0rkj4wd7kdb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42908838",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42908838"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Liver Disease Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Higher fibrosis-4 index is associated with 2-year cardiovascular events in Vietnamese adults with type 2 diabetes mellitus: a prospective cohort study.",
  "title_text": "Higher fibrosis-4 index is associated with 2-year cardiovascular events in Vietnamese adults with type 2 diabetes mellitus: a prospective cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/9b0rkj4wd7kdb",
  "venue": "Frontiers in gastroenterology (Lausanne, Switzerland)",
  "versions": []
}