The Impact of Type 2 Diabetes Mellitus on Hepatic Fibrosis in Patients with metabolic dysfunction-associated steatotic liver disease – a cross-sectional study

Aims: Evaluate the impact of type 2 diabetes on hepatic fibrosis in patients with MASLD. Materials and Methods: This cross-sectional study used retrospective data from patients with MASLD who underwent liver elastography between July 2022 and February 2024. Controlled Attenuation Parameter (CAP) ≥ 248 dB/m was considered diagnostic for steatosis; elasticity (kPa) of 8.7-10.2 kPa for F3 and >10.2 kPa for F4. Clinical, demographic, and laboratory data were collected. Other etiologies of liver disease were excluded. Patients were divided into Group 1 (with diabetes) and Group 2 (without diabetes). Results: A total of 252 individuals were included, 96 in Group 1 and 156 in Group 2. The mean age was 56 years, and the median body mass index (BMI) was 31.0 kg/m².There was a positive correlation between the degree of steatosis and the stage of fibrosis (p < 0.01). The prevalence of steatosis S3 was 83.3% in Group 1 versus 70.5% in Group 2 (p=0.022). Fibrosis F3/F4 was present in 45.8% of Group 1 compared to 12.2% of Group 2 (p<0.001), while presumed cirrhosis affected 33.3% of Group 1 and 6.4% of Group 2 (p < 0,001). Conclusions: Type 2 diabetes was associated with a higher degree of steatosis and more severe hepatic fibrosis in patients with MASLD, with presumed cirrhosis present in about one-third of patients with diabetes. Early diagnosis of MASLD in type 2 diabetes and screening for complications (cirrhosis and hepatocellular carcinoma) should be implemented.