Description
Considering the burden of metabolic dysfunction-associated steatotic liver disease (MASLD) in individuals with type 2 diabetes (T2D), this study aimed to identify factors associated with MASLD among adults with T2D. A retrospective cross-sectional study using data from the 'All of Us' NIH research program from 2021 to 2023 was conducted. MASLD was identified using ICD-9/10 and SNOMED codes. Various factors, including age, gender, race/ethnicity, health insurance, education, employment, household income, comorbidity burden measured by the Charlson Comorbidity Index (CCI), and social determinants of health (SDOH), such as deprivation index by zip code, food insecurity, housing instability, social cohesion, stable housing concern, neighborhood disorder, transportation related delayed care, were examined. Descriptive and multiple logistic regression analyses (with adjusted odds ratios, aORs) were conducted. A significance level of 0.05 was considered. Among 26,246 T2D patients identified (average age: 63.3 years), 8.2% had a recorded diagnosis of MASLD. Most patients were female (56.4%), non-Hispanic Whites (65.3%). Approximately 53% had less than a college education, 39% had an annual household income of <$50k, 38% had a high comorbidity burden (CCI 3), 23% reported food insecurity, and their average deprivation index was 0.3. Patients with CCI 3 (vs. CCI<3, aOR: 2.15), females (vs. males, aOR: 1.29), and those with less than a college education (vs. a college education and higher, aOR: 1.21) significantly had higher odds of MASLD, while patients who are retired (vs. employed, aOR:0.77), older individuals (aOR: 0.98), and non-Hispanic Blacks (vs. non-Hispanic Whites, aOR: 0.48) significantly had lower odds of MASLD. None of the SDOH considered in this study was significant. In conclusion, MASLD in T2D was more strongly associated with sociodemographic and comorbidity burden than with SDOH factors. Future work needs to examine whether broader social and structural factors contribute to the risk of MASLD.
Publication Info
2026.