Association of the metabolic dysfunction-associated steatotic liver disease with cardiovascular and kidney disease in patients with type 2 diabetes mellitus: a cross-sectional study.

PURPOSE: This study explored the link between liver fibrosis and left ventricular hypertrophy (LVH), a good indicator of cardiovascular disease (CVD), and chronic kidney disease (CKD) risk in type 2 diabetes mellitus (T2DM) patients.

METHODS

We analyzed data from 2,436 T2DM patients who visited our clinic between 2022 and 2024. Liver fibrosis was evaluated using NAFLD Fibrosis Score (NFS). We applied logistic regression to assess the relationship between liver fibrosis and LVH/CKD risk.

RESULTS

Among the 2,436 participants (63.79 % male, mean [SD] age 53.08 [12.65] years), the prevalence of LVH, and CKD was 38.88 %, and 34.69 %. Individuals with NFS-defined advanced fibrosis had significantly higher risks of LVH (OR 1.45, 95 % CI [1.16-1.81]) and CKD (OR 1.94, 95 % CI [1.56-2.41]), after adjusting for established cardiovascular risk markers. Results remained consistent regardless of body mass index (BMI), or lipid profile status. We also observed that worsening liver fibrosis was associated with a higher stage of cardiovascular-kidney-metabolic (CKM) syndrome.

CONCLUSIONS

Liver fibrosis is independently associated with increased LVH/CKD risk and CKM stage in T2DM patients. These findings indicate that metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive stage (liver fibrosis) should be introduced into the CKM staging structure to enhance risk stratification.