SUN-622 - Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Patients with Type 2 Diabetes Mellitus in Almaty: A Retrospective Cross-Sectional Study

Introduction: While metabolic dysfunction-associated steatotic liver disease (MASLD) is a well-known complication of type 2 diabetes (T2DM), we still lack a clear epidemiological picture for Central Asia. Our study set out to fill this gap by determining how common MASLD is and analyzing fibrosis profiles among hospitalized T2DM patients in Almaty, Kazakhstan.
Materials and

Methods: We conducted a retrospective review of 4,009 hospitalized patients (aged 25–80) between 2017 and 2019 in a tertiary care hospital. We included patients with confirmed T2DM and MASLD based on international and national standards, while excluding those with viral or autoimmune hepatitis, other forms of cirrhosis, or incomplete records. MASLD was identified through ultrasound and established indices like HSI, FLI, and NFS. For fibrosis staging, we used transient elastography (FibroScan®). All data were analyzed using SPSS v.23.0, applying χ² tests and binary logistic regression to find the most significant risk factors. AI disclosure: Gemini (Google) was used solely for linguistic refinement and formatting; the author reviewed and remains responsible for all factual content.

Results: Our findings show a strikingly high MASLD prevalence of 84.4%. Women were affected significantly more often than men (86.5% vs. 80.5%). Interestingly, over 92% of these women were over the age of 45, which points to a strong link with the postmenopausal period. Central obesity was almost universal in our group (94.2%), and waist circumference proved to be a powerful independent predictor of high metabolic risk. We also noticed a major gap in diagnostic results: while the NFS index suggested advanced fibrosis in over a quarter of patients (25.5%), FibroScan® confirmed it in only 1.2%. We believe this discrepancy stems from the chronic inflammation seen in T2DM and the technical difficulty of performing elastography in patients with severe obesity.

Conclusions: The fact that 84.4% of diabetic patients in Kazakhstan have MASLD highlights a pressing need for systematic screening. Postmenopausal women with central obesity are at particularly high risk. Our study also shows that relying on a single diagnostic tool can be misleading in cases of severe obesity. Instead, a multimodal approach that combines clinical indices with biochemistry is essential for accurate staging in this vulnerable population.
Keywords: MASLD, MASH, T2DM, obesity, steatosis, fibrosis, HSI, FLI, FibroScan.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*