Exploring the Prevalence and Coexistence of Metabolic Dysfunction-associated Steatotic Liver Disease in Type 2 Diabetes Mellitus Patients Using Ultrasound: A Cross-sectional Study.

Background: Type 2 diabetes Mellitus (T2DM) increases vulnerability to metabolic dysfunction-associated steatotic liver disease (MASLD). Therefore, this study aims to determine the prevalence and coexistence of MASLD in patients with T2DM using ultrasound.

Methods: This cross-sectional retrospective study included 168 patients with T2DM from multiple diabetes clinics in Abha City, Asir region, recruited between August 2023 and December 2023. Adult patients aged 18 and over with T2DM were included, and data was extracted from patient files. All patients were examined by ultrasound to determine the prevalence and coexistence of MASLD in patients with T2DM. Hepatic steatosis on Bmode ultrasound is qualitatively classified on a four-point scale: normal (0), mild (1), moderate (2), and severe (3).

Results: Out of 168 patients, 68.4% were identified with MASLD, mostly with diffuse liver (97.4%) diagnosed through ultrasound. MASLD was significantly higher in individuals with uncontrolled diabetes (72.5%) than those with controlled diabetes (46.2%), with a significant difference (p=0.015) and an odds ratio (OR) of 3.081, indicating uncontrolled diabetics are over three times more likely to develop MASLD. The uncontrolled group had a statistically significant larger liver size than the control group (13.6cm ±1.43 vs. 13.0cm ±1.20, respectively: [p=0.032, 95%CI 0.053-1.12]). Furthermore, a notable association was observed between increased BMI and the prevalence of MASLD in individuals with T2DM. Furthermore, no significant association was found between the duration of diabetes and the severity of MASLD, nor between the grading of MASLD and gender.

Conclusion: This study highlights a crucial association between uncontrolled diabetes and increased MASLD prevalence, emphasizing the importance of diabetes management in reducing MASLD risk.