Determinants of Metabolic Dysfunction-Associated Steatotic Liver Diseases in Patients with Type 2 Diabetes Mellitus

Background: Type 2 diabetes mellitus (T2DM) is one of the most complex metabolic disorders worldwide, with a continuously rising prevalence. T2DM is linked to multiple complications, among which metabolic dysfunction-associated steatotic liver disease (MASLD) has gained increasing recognition. MASLD is the leading cause of chronic liver disease and a major determinant of cirrhosis and hepatocellular carcinoma. This research aimed to estimate the prevalence of MASLD in a single-center outpatient diabetes clinic and explore the associated risk factors. Methods: The study included 170 adults previously diagnosed with T2DM. Data regarding disease duration, metabolic control, demographic characteristics, anthropometric parameters, and comorbidities were retrieved. Laboratory analyses and imaging investigations were conducted to assess liver status and MASLD presence. Results: The prevalence of MASLD was 76.47%. Patients with MASLD presented significantly higher body weight, waist circumference, and body mass index (all p < 0.0001). The MASLD population exhibited longer diabetes duration (p = 0.043) and poor metabolic control. The lipid profile showed higher LDL-cholesterol (p = 0.003) and triglycerides (p < 0.0001) and lower HDL-cholesterol (p = 0.0004). Insulin resistance indices illustrated significant differences, with higher METS-IR and lower eGDR in MASLD patients (both p < 0.0001). Conclusions: MASLD was highly prevalent in the evaluated population. Our findings suggest that MASLD occurrence is mainly associated with obesity, insulin resistance, inadequate glycemic control, and dyslipidemia. All these factors indicate an unfavorable metabolic profile in T2DM patients, underscoring the need for early liver function screening.