MASLD-related fibrosis, but not MASLD, is associated with left ventricular concentric hypertrophy in patients with type 2 diabetes.

PURPOSE: To assess the association of metabolic dysfunction-associated steatotic liver disease (MASLD) and related fibrosis with abnormal left ventricular (LV) geometry in patients with type 2 diabetes mellitus (T2DM).

METHODS

This cross-sectional study included 1026 participants with T2DM in Nanfang Metabolic Study who underwent FibroScan and echocardiography. MASLD and liver fibrosis was assessed by FibroScan with controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), which quantifies liver steatosis and fibrosis, respectively. LV geometry was evaluated by echocardiography, with patterns classified as: normal geometry, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. The association of MASLD and related fibrosis with risks of abnormal LV geometry patterns was assessed by multivariate logistic regression models, adjusted for 27 biomarkers detected by directed acyclic graph.

RESULTS

Participants had a mean age of 51.2 years, mean BMI of 25.0 kg/m2, and 633 (62%) were male. 579 (56%) of the participants had MASLD (CAP > 248 dB/m), 118 (12%) of whom had significant liver fibrosis (LSM > 7 kPa). Multivariate logistic regression analysis revealed that MASLD-related fibrosis, but not MASLD itself, was independently associated with LV concentric hypertrophy (odds ratio, 1.89; 95% confidence interval, 1.23 to 2.91; p = 0.004). Neither MASLD nor its related fibrosis was significantly associated with other abnormal LV geometry patterns.

CONCLUSIONS

Our findings indicated that MASLD-related fibrosis was independently associated with LV concentric hypertrophy in patients with T2DM.