Individuals with type 2 diabetes did not experience higher microvascular complication rates solely due to MASLD. Published in BMC Primary Care, the study highlights fibrosis severity as the key determinant of risk.

This cross-sectional analysis included 308 adults in primary care, with a median diabetes duration of 7 years. MASLD was present in 58.8% of participants based on magnetic resonance imaging proton density fat fraction or vibration-controlled transient elastography. Among those with MASLD, 52.3% had no advanced fibrosis, while 6.5% had fibrosis of ≥10 kPa. Reported complications included neuropathy (20.8%), retinopathy (19.5%), chronic kidney disease (19.2%), and diabetic foot ulcers (4.2%).

The results show that MASLD alone does not increase microvascular risk in type 2 diabetes. However, higher fibrosis stages were linked to greater complication burden, indicating that fibrosis progression rather than steatosis drives microvascular susceptibility.

These findings emphasize the value of routine fibrosis assessment to better identify individuals at elevated risk for kidney, nerve, and retinal complications in type 2 diabetes.