Association of Hepatic Steatosis Burden With Microalbuminuria in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study

Introduction Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a multisystem disorder associated with cardiometabolic complications. Emerging evidence suggests a potential link between hepatic steatosis and diabetic kidney disease, particularly microalbuminuria. This study aimed to evaluate the association between hepatic steatosis burden and urinary albumin-creatinine ratio (UACR) in patients with type 2 diabetes mellitus. Methods In this cross-sectional study, 95 patients with type 2 diabetes mellitus were evaluated. Hepatic steatosis was assessed using computed tomography-derived liver attenuation index (LAI) and steatosis grading. UACR was used as a marker of microalbuminuria. Correlation analysis and multivariate linear regression were performed to determine the relationship between hepatic steatosis parameters and albuminuria. Results The mean age of participants was 53.16 ± 9.94 years, with a mean BMI of 24.97 ± 2.03 kg/m². UACR increased progressively with higher grades of hepatic steatosis (Kruskal-Wallis H = 49.53, p < 0.001). LAI showed a significant negative correlation with UACR (r = −0.66, p < 0.001). In multivariate regression analysis, LAI (β = −1.69, p < 0.001) and BMI (β = 2.13, p = 0.004) were independently associated with UACR. Conclusion Hepatic steatosis burden is significantly associated with microalbuminuria in patients with type 2 diabetes mellitus, suggesting its potential role as an early marker of renal endothelial dysfunction.