Prevalence of high-risk for advanced liver fibrosis using non-invasive scores among type 2 diabetes mellitus patients in the United Arab Emirates: a retrospective cross-sectional study

Background: Advanced liver fibrosis is a major determinant of liver-related morbidity and mortality and occurs more frequently in individuals with type 2 diabetes mellitus (T2DM). While metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among patients with T2DM, data on the risk of advanced liver fibrosis in this population in the United Arab Emirates (UAE) remain limited. Non-invasive fibrosis scores offer a pragmatic approach for risk stratification in routine clinical practice. Aims: To determine the prevalence of high risk for advanced liver fibrosis and its clinical associations among patients with T2DM in the UAE using validated non-invasive fibrosis scores. Methodology: A retrospective cross-sectional study was conducted between October to December 2023, enrolling T2DM patients who attended at the Diabetic Care Centre in Dubai, UAE. Data was extracted from the Dubai Health electronic medical records, Epic (Salama). Liver fibrosis risk was assessed using the fibrosis-4 (FIB-4) score and Nonalcoholic Fatty Liver Disease (NAFLD) fibrosis score, with chi-square tests determining the statistical difference across liver fibrosis risk groups. Analyses were performed at a 5% significance level. Results: Among 373 patients, there was a slight female predominance (53%). Overall, 2.7% were at high risk of advanced liver fibrosis, while 56% had suspected hepatitis steatosis (MASLD), which aligns with global MASLD estimates in T2DM. Higher BMI was significantly associated with greater liver fibrosis risk (p=.002). Conclusion: A small but clinically relevant proportion of patients with T2DM in the UAE are at high risk for advanced liver fibrosis. Incorporating non-invasive fibrosis risk assessment into routine diabetes care may facilitate early detection and specialist referral.