Association between glucose time-in-range and the severity of metabolic dysfunction-associated steatotic liver disease in Chinese adults with type 2 diabetes mellitus.

Background: This study investigated the correlation between glucose time-in-range (TIR) and hepatic steatosis severity or liver fibrosis risk in Chinese adults with type 2 diabetes mellitus (T2DM) comorbid with metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods: Participants with T2DM were evaluated for hepatic steatosis and fibrosis using vibration-controlled transient elastography. TIR was calculated based on data from a retrospective continuous glucose monitoring system.

Results: A total of 184 T2DM patients with MASLD were enrolled. The controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) decreased with increasing TIR (p < 0.05). Spearman correlation showed negative correlations between CAP, LSM, and TIR (r = -0.824 and - 0.842, p < 0.05) and positive correlations with basal insulin resistance (HOMA-IR) (r = 0.205 and 0.208, p < 0.01). Multiple linear regression revealed TIR and HOMA-IR independently correlated with CAP (std. regression coefficients = -0.695 and 0.103, p < 0.05) and LSM (std. regression coefficients = -0.735 and 0.083, p < 0.05), wit0.34 h TIR having a stronger impact. Binary logistic regression showed TIR Groups 3 (70% ≥ TIR < 85%) and 4 (TIR ≥ 85%) were protective for MASLD (OR = 0.26 and 0.11, 95% CI 0.10-0.66 and 0.04-0.29, P = 0.005 and < 0.001) and liver fibrosis (OR = 0.29 and 0.13, 95% CI 0.12-0.74 and 0.05-0.36, P = 0.010 and < 0.001) compared to TIR Group 1 (lowest quartile).

Conclusion: In T2DM patients with coexisting MASLD, a significant and independent association existed between TIR and the severity of hepatic steatosis.

Clinical trial number: Not applicable.