Background: To investigate the association between serum meteorin-like protein (Metrnl) and metabolic dysfunction-associated steatotic liver disease (MASLD) in type 2 diabetes mellitus (T2DM), and evaluate its incremental discriminatory value beyond the Hepatic Steatosis Index (HSI). Methods: This cross-sectional study enrolled 198 T2DM patients (110 T2DM-only; 88 T2DM+MASLD). Metrnl levels were measured via ELISA. Multivariable and ordinal logistic regressions assessed the independent association between Metrnl and MASLD presence and ultrasonographic severity, adjusting for clinical confounders. Discriminatory performance was evaluated using ROC analyses and likelihood-ratio tests. Results: Serum Metrnl was significantly lower in the T2DM+MASLD group versus T2DM-only (0.65 0.46, 0.82 vs. 0.75 0.62, 0.88 ng/mL, P=0.007). After full adjustment for adiposity, lipids, liver enzymes, and insulin resistance, lower Metrnl remained independently associated with higher MASLD risk (OR=0.238, 95% CI: 0.061-0.931, P=0.039) and greater steatosis severity (P<0.001). Adding Metrnl to HSI significantly improved the diagnostic model fit (AUC increased from 0.727 to 0.747, P=0.011). Conclusion: Decreased serum Metrnl is independently associated with MASLD presence and severity in T2DM, irrespective of obesity and insulin resistance. Metrnl serves as a distinct metabolic correlate, offering modest incremental value in multiparameter risk assessment models.
Zhuang et al. (Fri,) studied this question.
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