[Predictive factors for MASLD in type 2 diabetes: 1 year follow-up study]

It has been proposed the current nomenclature for metabolic dysfunction-associated steatotic liver disease (MASLD) as a general term to encompass the various etiologies of steatosis and to include the presence of at least 1 of 5 cardiometabolic risk factors.

To evaluate the predictors of the incidence of MASLD in patients with type 2 diabetes (T2D) in primary care at a one-year follow-up.

Prospective cohort study including patients (n = 5143) with ≤ 15 years from diagnosis of T2D, treated at primary care units in Mexico City and metropolitan area. At baseline and at one-year follow-up were measured: anthropometry, HbA1c, microalbuminuria, creatinine, lipid profile and hepatic markers aspartate aminotransferase and alanine aminotransferase (ALT). Hepatic Steatosis Index (HSI) and Lipidic Accumulation Product (LAP) were calculated. MASLD was considered as cases with abnormal ALT.

At baseline, 1449 (28.2%) patients presented MASLD. The HSI and LAP indices were higher in MASLD. Age at diagnosis and time of exposure to T2D were inversely associated with MASLD, and directly proportional to body mass index, waist circumference (WC) and HbA1c. Of the cases with MASLD at baseline, 452 (38.8%) reverted to normal and 712 (61.2%) persisted after follow-up. ORs for MASLD were 1.86 and 1.88 for HbA1c and WC, respectively.

The combination of HSI, LAP and screening with HbA1c and WC are useful to identify MASLD in patients with T2D.