Prevalence and Risk Factors of Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients With Type 2 Diabetes Mellitus at a Tertiary Center in Saudi Arabia: Cross-Sectional Questionnaire Study.

Background: The escalating rates of obesity and type 2 diabetes mellitus (T2DM) in Saudi Arabia highlight the impending burden of metabolic dysfunction-associated steatotic liver disease (MASLD) and nonalcoholic steatohepatitis. Objective: This study aimed to identify MASLD among patients with T2DM at King Saud Medical City family medicine clinics, Riyadh, and explore associated factors to facilitate early intervention and prevention strategies. Methods: This cross-sectional study identified patients with T2DM who attended King Saud Medical City, Riyadh, underwent an abdominal ultrasound, and were diagnosed with MASLD. The study data were collected by a peer-reviewed validated data extraction sheet and analyzed by SPSS (version 26.0; IBM Corp). Results: Our study included 292 participants, with 47.3% (n=138) males and 52.7% (n=154) females. Notably, the prevalence of MASLD was 54.5% (n=159). Prevalent comorbidities included dyslipidemia (218/292, 74.7%) and hypertension (209/292, 71.6%). Most participants were nonsmokers (218/292, 74.7%). Higher waist circumference was significantly associated with MASLD (P=.02), with >80 cm among females (85/141, 60.3%) and >94 cm among males (60/141, 54.5%) affected across different stages of MASLD. Obesity (BMI>30 kg/m2) also significantly correlated with MASLD (P<.001). Individuals taking aspirin had half the odds of MASLD development (odds ratio [OR] 0.523, 95% CI 0.331-0.844; P=.007). Biochemical analysis revealed significant associations between MASLD and elevated alanine aminotransferase (P=.009), aspartate aminotransferase (P=.01), and homeostatic model assessment of insulin resistance (P=.001). Total cholesterol (P=.01), triglycerides (P=.03), and low-density lipoprotein (P=.04) were significantly elevated in patients with MASLD. Insulin exhibited a significant positive correlation with MASLD (r=0.24; P=.001). Glucose levels showed no significant association (r=0.03; P=.63). Conclusions: Our study highlights significant associations between MASLD and various factors, including waist circumference, obesity, and certain biochemical markers. Furthermore, the protective effect of aspirin against MASLD warrants further investigation. These findings underscore the importance of early intervention and targeted preventive strategies.