Introduction/Objectives: The prevalence of metabolic dysfunction-associated steatohepatitis (MASH) in patients with type 2 diabetes mellitus (T2DM) in US is around 30% and about 20% of patients have liver fibrosis. This study aims to explore the effect of glycemic control in T2DM patients on the diagnosis of At-risk MASH (MASH + Fibrosis≥2) by means of three non-invasive tests (MASEF score, FIB-4 and Fibroscan).
Methods: The study included 275 biopsy-proven MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) patients with T2DM. Patients were categorized as good glycemic control (GHb≤7%) and poor glycemic control (GHb>7%). A nested case-control study design was used, matching cohorts for age, BMI, gender and MASLD diagnosis. This process resulted in 97 patients in each group, with no significant differences in age (p=0.831), BMI (p=0.989), gender (p=0.991), and histology (p=0.714). MASEF score (non-invasive test based on metabolomics), FIB-4 and Fibroscan performance were compared to biopsy for the assessment of at-risk MASH.
Results: MASEF score (N=97/97), FIB-4 (N=83/87) and Fibroscan (N=54/54) performances in both cohorts were, respectively: GHb≤7%: AUC=0.76/0.77/0.75; GHb>7%: AUC=0.75/0.67/0.77. There were no significant differences among the three methods for the detection of at-risk MASH in patients with good and poor glycemic control, except for FIB-4 that showed a lower performance on GHb>7% cohort (p=0.01).
Conclusions: Glycemic control does not significantly influence the diagnosis of at-risk MASH in patients with T2DM when using MASEF score or Fibroscan as diagnostic tools.
I. Martínez-Arranz: None. M. Arrese: None. R. Mayo: None. I. Mincholé: None. M. Blanco: None. P. Aspichueta: None. C. Alonso: Employee; RUBIÓ METABOLOMICS. J. Banales: Advisory Panel; Owl-Rubio Metabolomics.
