GE Portuguese journal of gastroenterology · 2026
The Impact of Type 2 Diabetes Mellitus on Hepatic Fibrosis in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease: A Cross-Sectional Study.
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Mesquita Paula, Macedo Cristiane, Matos Ana, Henriques Carla, Carvalho Armando, Simão Adélia
Аннотация
AIMS: The aim of the study was to 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 ≥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 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.
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 ≥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 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.