Prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease with Clinically Significant Fibrosis in Obese Patients with Type 2 Diabetes Mellitus - China, 2017-2024.

What is already known about this topic?: Metabolic dysfunction-associated steatotic liver disease (MASLD) with clinically significant fibrosis substantially elevates the risk of liver-related complications and mortality. The American Diabetes Association consensus report specifically recommends systematic risk stratification for MASLD and hepatic fibrosis in patients with type 2 diabetes mellitus (T2DM), with particular emphasis on those presenting with obesity. What is added by this report?: This multicenter study demonstrates that obese patients with T2DM exhibit a substantially elevated prevalence of MASLD with clinically significant fibrosis compared to their non-obese counterparts (26.7% vs. 8.4%). Furthermore, the prevalence escalates progressively with the accumulation of cardiometabolic risk factors, highlighting the synergistic impact of multiple metabolic abnormalities on hepatic fibrosis development. What are the implications for public health practice?: Our findings underscore the critical need for routine screening and integrated management of MASLD with clinically significant fibrosis in patients with T2DM, particularly those presenting with obesity and multiple cardiometabolic risk factors.