Supplementary Material for: The Impact of Type 2 Diabetes Mellitus on Hepatic Fibrosis in Patients with metabolic dysfunction-associated steatotic liver disease – a cross-sectional study

Aims: 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 (CAP) ≥ 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 (BMI) 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.

研究目的：评估2型糖尿病对代谢相关脂肪性肝病（MASLD）患者肝纤维化的影响。
材料与方法：本横断面研究采用2022年7月至2024年2月期间接受肝脏弹性成像检查的MASLD患者的回顾性数据。以受控衰减参数（CAP）≥248 dB/m作为脂肪变性的诊断标准；肝弹性值8.7~10.2 kPa对应F3期肝纤维化，＞10.2 kPa对应F4期肝纤维化。收集患者的临床资料、人口统计学信息及实验室检查结果，排除其他病因导致的肝脏疾病。将患者分为糖尿病组（第1组）与非糖尿病组（第2组）。
结果：本研究共纳入252例患者，其中第1组96例，第2组156例。患者的平均年龄为56岁，中位体质量指数（BMI）为31.0 kg/m²。脂肪变性程度与肝纤维化分期呈正相关（p＜0.01）。第1组S3级脂肪变性的患病率为83.3%，第2组为70.5%（p=0.022）。第1组F3/F4期肝纤维化的患病率为45.8%，显著高于第2组的12.2%（p＜0.001）；第1组疑似肝硬化的检出率为33.3%，第2组仅为6.4%（p＜0.001）。
结论：2型糖尿病与MASLD患者更高程度的脂肪变性及更严重的肝纤维化相关，约三分之一的糖尿病患者合并疑似肝硬化。临床中应重视2型糖尿病患者的MASLD早期诊断，并开展并发症（肝硬化及肝细胞癌）的筛查工作。