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Volume 21, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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Abstract

Background

Type 2 diabetes Mellitus (T2DM) increases vulnerability to metabolic dysfunction-associated steatotic liver disease (MASLD). Therefore, this study aims to determine the prevalence and coexistence of MASLD in patients with T2DM using ultrasound.

Methods

This cross-sectional retrospective study included 168 patients with T2DM from multiple diabetes clinics in Abha City, Asir region, recruited between August 2023 and December 2023. Adult patients aged 18 and over with T2DM were included, and data was extracted from patient files. All patients were examined by ultrasound to determine the prevalence and coexistence of MASLD in patients with T2DM. Hepatic steatosis on B-mode ultrasound is qualitatively classified on a four-point scale: normal (0), mild (1), moderate (2), and severe (3).

Results

Out of 168 patients, 68.4% were identified with MASLD, mostly with diffuse liver (97.4%) diagnosed through ultrasound. MASLD was significantly higher in individuals with uncontrolled diabetes (72.5%) than those with controlled diabetes (46.2%), with a significant difference (=0.015) and an odds ratio (OR) of 3.081, indicating uncontrolled diabetics are over three times more likely to develop MASLD. The uncontrolled group had a statistically significant larger liver size than the control group (13.6cm ±1.43 . 13.0cm ±1.20, respectively: [=0.032, 95%CI 0.053-1.12]). Furthermore, a notable association was observed between increased BMI and the prevalence of MASLD in individuals with T2DM. Furthermore, no significant association was found between the duration of diabetes and the severity of MASLD, nor between the grading of MASLD and gender.

Conclusion

This study highlights a crucial association between uncontrolled diabetes and increased MASLD prevalence, emphasizing the importance of diabetes management in reducing MASLD risk.

© 2025 Zhang et al.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2025-01-01
2025-04-25

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References

  1. RinellaM.E. LazarusJ.V. RatziuV. FrancqueS.M. SanyalA.J. KanwalF. RomeroD. AbdelmalekM.F. AnsteeQ.M. ArabJ.P. ArreseM. BatallerR. BeuersU. BoursierJ. BugianesiE. ByrneC.D. Castro NarroG.E. ChowdhuryA. Cortez-PintoH. CryerD.R. CusiK. El-KassasM. KleinS. EskridgeW. FanJ. GawriehS. GuyC.D. HarrisonS.A. KimS.U. KootB.G. KorenjakM. KowdleyK.V. LacailleF. LoombaR. Mitchell-ThainR. MorganT.R. PowellE.E. RodenM. Romero-GómezM. SilvaM. SinghS.P. SookoianS.C. SpearmanC.W. TiniakosD. ValentiL. VosM.B. WongV.W.S. XanthakosS. YilmazY. YounossiZ. HobbsA. Villota-RivasM. NewsomeP.N. NAFLD Nomenclature consensus group A multisociety Delphi consensus statement on new fatty liver disease nomenclature.Hepatology20237861966198610.1097/HEP.000000000000052037363821
     [Google Scholar]
  2. LoombaR. FriedmanS.L. ShulmanG.I. Mechanisms and disease consequences of nonalcoholic fatty liver disease.Cell2021184102537256410.1016/j.cell.2021.04.01533989548
     [Google Scholar]
  3. YounossiZ.M. GolabiP. de AvilaL. PaikJ.M. SrishordM. FukuiN. QiuY. BurnsL. AfendyA. NaderF. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis.J. Hepatol.201971479380110.1016/j.jhep.2019.06.02131279902
     [Google Scholar]
  4. KleinerD.E. BruntE.M. Van NattaM. BehlingC. ContosM.J. CummingsO.W. FerrellL.D. LiuY.C. TorbensonM.S. Unalp-AridaA. YehM. McCulloughA.J. SanyalA.J. Nonalcoholic Steatohepatitis Clinical Research Network Design and validation of a histological scoring system for nonalcoholic fatty liver disease.Hepatology20054161313132110.1002/hep.2070115915461
     [Google Scholar]
  5. DharmalingamM. YamasandhiP.G. Nonalcoholic fatty liver disease and Type 2 diabetes mellitus.Indian J. Endocrinol. Metab.201822342142810.4103/ijem.IJEM_585_1730090738
     [Google Scholar]
  6. AnsteeQ.M. McPhersonS. DayC.P. How big a problem is non-alcoholic fatty liver disease?BMJ2011343jul18 1d389710.1136/bmj.d389721768191
     [Google Scholar]
  7. WongW.K. ChanW.K. Nonalcoholic fatty liver disease: A global perspective.Clin. Ther.202143347349910.1016/j.clinthera.2021.01.00733526312
     [Google Scholar]
  8. YounossiZ.M. Non-alcoholic fatty liver disease – A global public health perspective.J. Hepatol.201970353154410.1016/j.jhep.2018.10.03330414863
     [Google Scholar]
  9. AsraniS.K. DevarbhaviH. EatonJ. KamathP.S. Burden of liver diseases in the world.J. Hepatol.201970115117110.1016/j.jhep.2018.09.01430266282
     [Google Scholar]
  10. KanwalF. ShubrookJ.H. AdamsL.A. PfotenhauerK. Wai-Sun WongV. WrightE. AbdelmalekM.F. HarrisonS.A. LoombaR. MantzorosC.S. BugianesiE. EckelR.H. KaplanL.M. El-SeragH.B. CusiK. Clinical care pathway for the risk stratification and management of patients with nonalcoholic fatty liver disease.Gastroenterology202116151657166910.1053/j.gastro.2021.07.04934602251
     [Google Scholar]
  11. KhalifaA. RockeyD.C. The utility of liver biopsy in 2020.Curr. Opin. Gastroenterol.202036318419110.1097/MOG.000000000000062132097176
     [Google Scholar]
  12. RockeyD.C. CaldwellS.H. GoodmanZ.D. NelsonR.C. SmithA.D. American Association for the Study of Liver Diseases Liver biopsy.Hepatology20094931017104410.1002/hep.2274219243014
     [Google Scholar]
  13. European Association for the Study of the Liver (EASL) European Association for the Study of Diabetes (EASD) European Association for the Study of Obesity (EASO) (EASD. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease.Obes. Facts201692659010.1159/00044334427055256
     [Google Scholar]
  14. HernaezR. LazoM. BonekampS. KamelI. BrancatiF.L. GuallarE. ClarkJ.M. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: A meta-analysis.Hepatology20115431082109010.1002/hep.2445221618575
     [Google Scholar]
  15. PetzoldG. Role of ultrasound methods for the assessment of NAFLD.J. Clin. Med.20221115458110.3390/jcm1115458135956196
     [Google Scholar]
  16. SbernaA.L. BouilletB. RoulandA. BrindisiM.C. NguyenA. MouillotT. DuvillardL. DenimalD. LoffroyR. VergèsB. HillonP. PetitJ.M. European association for the study of the liver ( EASL ), european association for the study of diabetes ( EASD ) and european association for the study of obesity ( EASO ) clinical practice recommendations for the management of non‐alcoholic fatty liver disease: Evaluation of their application in people with type 2 diabetes.Diabet. Med.201835336837510.1111/dme.1356529247558
     [Google Scholar]
  17. KosmalskiM. ZiółkowskaS. CzarnyP. SzemrajJ. PietrasT. The coexistence of nonalcoholic fatty liver disease and type 2 diabetes mellitus.J. Clin. Med.2022115137510.3390/jcm1105137535268466
     [Google Scholar]
  18. CiardulloS. VerganiM. PerseghinG. Nonalcoholic fatty liver disease in patients with type 2 diabetes: Screening, diagnosis, and treatment.J. Clin. Med.20231217559710.3390/jcm1217559737685664
     [Google Scholar]
  19. van WervenJ.R. MarsmanH.A. NederveenA.J. SmitsN.J. ten KateF.J. van GulikT.M. StokerJ. Assessment of hepatic steatosis in patients undergoing liver resection: comparison of US, CT, T1-weighted dual-echo MR imaging, and point-resolved 1H MR spectroscopy.Radiology2010256115916810.1148/radiol.1009179020574093
     [Google Scholar]
  20. MitraS. DeA. ChowdhuryA. Epidemiology of non-alcoholic and alcoholic fatty liver diseases.Transl. Gastroenterol. Hepatol.202051610.21037/tgh.2019.09.0832258520
     [Google Scholar]
  21. Portillo-SanchezP. BrilF. MaximosM. LomonacoR. BiernackiD. OrsakB. SubbarayanS. WebbA. HechtJ. CusiK. High prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus and normal plasma aminotransferase levels.J. Clin. Endocrinol. Metab.201510062231223810.1210/jc.2015‑196625885947
     [Google Scholar]
  22. FanN. ZhangL. XiaZ. PengL. WangY. PengY. Sex‐specific association between serum uric acid and nonalcoholic fatty liver disease in type 2 diabetic patients.J. Diabetes Res.2016201611610.1155/2016/380537227382573
     [Google Scholar]
  23. GuoK. ZhangL. LuJ. YuH. WuM. BaoY. ChenH. JiaW. Non-alcoholic fatty liver disease is associated with late but not early atherosclerotic lesions in Chinese inpatients with type 2 diabetes.J. Diabetes Complications2017311808510.1016/j.jdiacomp.2016.09.00827742552
     [Google Scholar]
  24. YiM. ChenR.P. YangR. ChenH. Increased prevalence and risk of non‐alcoholic fatty liver disease in overweight and obese patients with Type 2 diabetes in South China.Diabet. Med.201734450551310.1111/dme.1317427334577
     [Google Scholar]
  25. SimaA. TimarR. VladA. TimarB. RosuM. DanI. SirliR. PopescuA. SporeaI. Nonalcoholic fatty liver disease: A frequent condition in type 2 diabetic patients.Wien. Klin. Wochenschr.201412611-1233534010.1007/s00508‑014‑0530‑824652019
     [Google Scholar]
  26. RashidA. ZafarS. BashirA. BakhtK. BhalliA.U. Presence of non-alcoholic fatty liver disease in patients of uncontrolled and controlled type 2 diabetes mellitus.Pak. Armed Forces Med. J.2019694822825
     [Google Scholar]
  27. MoonS.S. Relationship between serum uric acid level and nonalcoholic fatty liver disease in pre- and postmenopausal women.Ann. Nutr. Metab.201362215816310.1159/00034620223406781
     [Google Scholar]
  28. KwonYM OhSW HwangSS LeeC KwonH ChungGE Association of nonalcoholic fatty liver disease with components of metabolic syndrome according to body mass index in Korean adults.Am. J. Gastroenterol.2012107121852185810.1038/ajg.2012.314
     [Google Scholar]
  29. AliA. AminM.J. AhmedM.U. TajA. AasimM. TabrezE. Frequency of non-alcoholic fatty liver disease (NAFLD) and its associated risk factors among Type-2 diabetics.Pak. J. Med. Sci.2022381283335035396
     [Google Scholar]
  30. McPhersonS. HardyT. HendersonE. BurtA.D. DayC.P. AnsteeQ.M. Evidence of NAFLD progression from steatosis to fibrosing-steatohepatitis using paired biopsies: Implications for prognosis and clinical management.J. Hepatol.20156251148115510.1016/j.jhep.2014.11.03425477264
     [Google Scholar]
  31. PaisR. CharlotteF. FedchukL. BedossaP. LebrayP. PoynardT. RatziuV. LIDO Study Group A systematic review of follow-up biopsies reveals disease progression in patients with non-alcoholic fatty liver.J. Hepatol.201359355055610.1016/j.jhep.2013.04.02723665288
     [Google Scholar]
  32. PatelH. VermaY.N. Prevalence of non-alcoholic fatty liver disease in type-2 diabetes mellitus patients.Int. J. Res. Med. Sci.2018641322132610.18203/2320‑6012.ijrms20181290
     [Google Scholar]
  33. LvW.S. SunR.X. GaoY.Y. WenJ.P. PanR.F. LiL. WangJ. XianY.X. CaoC.X. ZhengM. Nonalcoholic fatty liver disease and microvascular complications in type 2 diabetes.World J. Gastroenterol.201319203134314210.3748/wjg.v19.i20.313423716995
     [Google Scholar]
  34. WilliamsonR.M. PriceJ.F. GlancyS. PerryE. NeeL.D. HayesP.C. FrierB.M. Van LookL.A.F. JohnstonG.I. ReynoldsR.M. StrachanM.W.J. Edinburgh Type 2 Diabetes Study Investigators Prevalence of and risk factors for hepatic steatosis and nonalcoholic Fatty liver disease in people with type 2 diabetes: The edinburgh type 2 diabetes study.Diabetes Care20113451139114410.2337/dc10‑222921478462
     [Google Scholar]
/content/journals/cmir/10.2174/0115734056354807241217043210
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Exploring the Prevalence and Coexistence of Metabolic Dysfunction-associated Steatotic Liver Disease in Type 2 Diabetes Mellitus Patients Using Ultrasound: A Cross-sectional Study
Curr. Med. Imaging 21, e15734056354807 (2025); https://doi.org/10.2174/0115734056354807241217043210
/content/journals/cmir/10.2174/0115734056354807241217043210
/content/journals/cmir/10.2174/0115734056354807241217043210
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  • Article Type:     Research Article
Keyword(s): BMI; Controlled diabetes; MASLD; Type 2 diabetic mellitus; Ultrasound; Uncontrolled diabetes

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