Prevalence and steatosis severity of MASLD in patients with type 2 diabetes mellitus in Kuwait
9 affiliations
- 1Unit of Gastroenterology and Transplant Hepatology, Thunayan Al Ghanim Gastroenterology Center, Al Amiri Hospital
- 2Department of Pharmacology, Faculty of Medicine, Kuwait University
- 3Department of Translational Research, Dasman Diabetes Institute
- 4Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute
- 5National Dasman Diabetes Biobank, Dasman Diabetes Institute
- 6Department of Pharmacology, Faculty of Pharmacy, Kuwait University
- 7Program of Medicine, College of Medicine and Health Sciences, Abdullah Al Salem University
- 8Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Health Sciences Center, Kuwait University
- 9Division of Diabetes, University of Texas Health Science Center
Abstract
Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a common comorbidity in individuals with type 2 diabetes mellitus (T2DM). Given the high prevalence of T2DM in Kuwait and limited regional data on hepatic steatosis, this study aimed to assess the prevalence and severity of liver steatosis among T2DM patients attending Dasman Diabetes Institute (DDI).
Methods: A total of 267 T2DM patients (mean age, 53.2 ± 9.8 years; 67.4% men and 32.6% women) were evaluated using vibration-controlled transient elastography (VCTE; FibroScan) to determine liver steatosis through controlled attenuation parameter (CAP) scores. MASLD was classified based on CAP thresholds: S0 (<238 dB/m), S1 (238–259 dB/m), S2 (260–290 dB/m), and S3 (>290 dB/m). Liver stiffness measurement (LSM) was used to estimate fibrosis severity.
Results: Hepatic steatosis (S1–S3) was present in 72.7% (n = 194) of participants, with 40.8% (n = 109) exhibiting severe steatosis (S3), 20.6% (n = 55) moderate steatosis (S2), and 11.2% (n = 30) mild steatosis (S1). Minimal or no fibrosis (F0–F1) was present in 92.5% (n = 247), while moderate fibrosis (F2) was present in 4.1% (n=11), and advanced fibrosis (F3–F4) was identified in 3.4% (n = 9) of the cohort. CAP scores showed significant positive associations with BMI (ρ = 0.32, p < 0.001), waist circumference (ρ = 0.200, p = 0.001), triglycerides (ρ = 0.310, p < 0.001), ALT (ρ = 0.325, p < 0.001), AST (ρ = 0.197, p = 0.002), and GGT (ρ = 0.203, p = 0.001), while an inverse correlation was observed with HDL-C (ρ = −0.19, p = 0.003). In multivariable linear regression analyses, CAP score remained independently associated with BMI, ALT, and LSM. Conversely, LSM was associated significantly with CAP score, BMI, ALT, AST, and GGT.
Conclusion: In this studied Kuwaiti cohort, MASLD was present in over 70% of adults with T2DM, with a substantial subset exhibiting advanced steatosis. The severity of both steatosis and fibrosis showed significant associations with metabolic and hepatic biomarkers, reinforcing their pathophysiological linkage. These findings support the integration of standardized liver disease risk stratification into routine diabetes care, particularly in populations at elevated cardiometabolic risk.
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BibTeX
@article{altarrah2026prevalence,
title = {{Prevalence and steatosis severity of MASLD in patients with type 2 diabetes mellitus in Kuwait}},
author = {Munira Altarrah and Rashed Alhammad and Saoud Ahmad and Mohamed Abu-Farha and Sriraman Devarajan and Shaymaa Alhaddad and Abeer Afyoni and Fouz AlHaifi and Mohamed Qaddoumi and Mohammad Shehab and Mohamed Salah and Hamad Ali and Muhammed Abdul Ghani and Fahd Al-Mulla and Fahad Alajmi and Jehad Abubaker},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1963647},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1963647/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prevalence and steatosis severity of MASLD in patients with type 2 diabetes mellitus in Kuwait
AU - Munira Altarrah
AU - Rashed Alhammad
AU - Saoud Ahmad
AU - Mohamed Abu-Farha
AU - Sriraman Devarajan
AU - Shaymaa Alhaddad
AU - Abeer Afyoni
AU - Fouz AlHaifi
AU - Mohamed Qaddoumi
AU - Mohammad Shehab
AU - Mohamed Salah
AU - Hamad Ali
AU - Muhammed Abdul Ghani
AU - Fahd Al-Mulla
AU - Fahad Alajmi
AU - Jehad Abubaker
PY - 2026
DA - 2026/10/13
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1963647
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1963647/full
AB - Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a common comorbidity in individuals with type 2 diabetes mellitus (T2DM). Given the high prevalence of T2DM in Kuwait and limited regional data on hepatic steatosis, this study aimed to assess the prevalence and severity of liver steatosis among T2DM patients attending Dasman Diabetes Institute (DDI). Methods: A total of 267 T2DM patients (mean age, 53.2 ± 9.8 years; 67.4% men and 32.6% women) were evaluated using vibration-controlled transient elastography (VCTE; FibroScan) to determine liver steatosis through controlled attenuation parameter (CAP) scores. MASLD was classified based on CAP thresholds: S0 (<238 dB/m), S1 (238–259 dB/m), S2 (260–290 dB/m), and S3 (>290 dB/m). Liver stiffness measurement (LSM) was used to estimate fibrosis severity. Results: Hepatic steatosis (S1–S3) was present in 72.7% (n = 194) of participants, with 40.8% (n = 109) exhibiting severe steatosis (S3), 20.6% (n = 55) moderate steatosis (S2), and 11.2% (n = 30) mild steatosis (S1). Minimal or no fibrosis (F0–F1) was present in 92.5% (n = 247), while moderate fibrosis (F2) was present in 4.1% (n=11), and advanced fibrosis (F3–F4) was identified in 3.4% (n = 9) of the cohort. CAP scores showed significant positive associations with BMI (ρ = 0.32, p < 0.001), waist circumference (ρ = 0.200, p = 0.001), triglycerides (ρ = 0.310, p < 0.001), ALT (ρ = 0.325, p < 0.001), AST (ρ = 0.197, p = 0.002), and GGT (ρ = 0.203, p = 0.001), while an inverse correlation was observed with HDL-C (ρ = −0.19, p = 0.003). In multivariable linear regression analyses, CAP score remained independently associated with BMI, ALT, and LSM. Conversely, LSM was associated significantly with CAP score, BMI, ALT, AST, and GGT. Conclusion: In this studied Kuwaiti cohort, MASLD was present in over 70% of adults with T2DM, with a substantial subset exhibiting advanced steatosis. The severity of both steatosis and fibrosis showed significant associations with metabolic and hepatic biomarkers, reinforcing their pathophysiological linkage. These findings support the integration of standardized liver disease risk stratification into routine diabetes care, particularly in populations at elevated cardiometabolic risk.
SN - 1664-2392
ER -