Can the Finnish Diabetes Risk Score (FINDRISC) be used to predict liver fibrosis risk instead of the fibrosis-4 index (FIB-4)?

BACKGROUND: FINDRISC is a non-invasive, easy-to-use, and free screening tool developed to estimate the 10-year risk of developing type 2 diabetes mellitus (T2DM). OBJECTIVE: This study aimed to investigate whether FINDRISC can also predict liver fibrosis risk, as measured by the fibrosis-4 index (FIB-4) in individuals without a diagnosis of T2DM. METHODS: This retrospective cross-sectional study included 1329 adults aged ≥18 years without prior T2DM, based on records from a Family Health Center in Turkey. The FINDRISC results used in T2DM screening were analyzed retrospectively from patient records. FINDRISC scores were calculated from questionnaire results, and FIB-4 was derived from laboratory data (age, alanine aminotransferase, aspartate aminotransferase, platelet count). Chi-square, correlation, and regression analyses were performed, adjusting for gender, smoking, alcohol use, physical activity, and marital status. RESULTS: Mean FINDRISC scores and FIB-4 were 11.88 ± 6.22 and 1.01 ± 0.80, respectively. Higher FINDRISC categories were associated with older age, female sex, non-smoking, physical inactivity, and obesity. A moderate positive correlation was observed between FINDRISC and FIB-4 (rho = 0.427, P < 0.001). In multivariable regression, FINDRISC emerged as an independent predictor of FIB-4 (β = 0.250, P < 0.001), increasing model variance explained from 6.4% to 12.3%. CONCLUSION: FINDRISC, beyond its established role in T2DM risk stratification, may serve as a dual, non-invasive, and free screening tool to identify individuals at increased risk of liver fibrosis. Thanks to its simplicity and self-administered nature, individuals can easily complete the questionnaire at home, enabling early diagnosis of both T2DM and liver fibrosis risk.