Low Rates of MASLD Screening in Young Adults With Type 2 Diabetes: A Retrospective Cohort Study

Area of Science:

• Hepatology
• Endocrinology
• Cardiology

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 70% of adults with type 2 diabetes (T2D), increasing risks for MASH, fibrosis, and cirrhosis.
• Current research often overlooks the prevalence and screening of MASLD in younger adult populations with T2D.

Purpose of the Study:

• To assess the frequency of MASLD screening in young adults diagnosed with T2D who receive outpatient care.
• To highlight the need for improved screening protocols for MASLD in this demographic.

Main Methods:

• A retrospective cohort study analyzed data from young adults (18-44 years) with T2D treated at a tertiary care center between 2018 and 2022.
• At-risk metabolic dysfunction-associated steatohepatitis (MASH) was diagnosed using vibration-controlled transient elastography, MRE, or liver biopsy.

Main Results:

• Out of 6891 participants, 16% had MASLD, with higher rates of cardiometabolic risk factors and cardiovascular disease compared to those without MASLD.
• Only 12% of MASLD patients underwent further investigation, with dyslipidemia, elevated ALT, or multiple diabetes medications being significant associated factors.
• Among those investigated, 38% had at-risk MASH, and the FIB-4 index was elevated in 16% of MASLD patients.

Conclusions:

• Screening for MASLD in young adults with T2D is frequently inadequate.
• There's a critical need for enhanced awareness and accurate noninvasive tools for screening at-risk MASH in young adults with T2D to prevent disease progression.