Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in patients with type 2 diabetes mellitus (T2DM), but practical non-invasive screening approaches remain limited in routine clinical care. A cross-sectional study published in Cardiovascular Diabetology evaluated whether lipid accumulation product (LAP) could help identify prevalent MASLD in hospitalized adults with T2DM.

The analysis included 495 inpatients with T2DM and assessed the association between log10-transformed LAP and MASLD prevalence. Using the Boruta feature-selection algorithm, the analysis identified log10LAP as the most robust indicator associated with MASLD among evaluated variables. External validation was performed using an independent National Health and Nutrition Examination Survey (NHANES) cohort involving 630 participants.

Findings

• Higher log10LAP was independently associated with MASLD (OR 1.83; 95% CI 1.43-2.35).
• Optimal sex-specific cutoffs were 20.4 for men and 27.0 for women, with a positive predictive value of 85.93%.
• Discriminative performance was highest in patients younger than 55 years (AUC 0.855).
• Reliable discrimination was maintained in non-obese patients (AUC 0.711).
• Decision curve analysis showed greater net benefit for the LAP-based model than a “screen-all” strategy at threshold probabilities greater than 0.20.
• External NHANES validation confirmed independent associations between LAP and MASLD risk (P < 0.05).

The findings suggest that LAP may help support non-invasive MASLD screening in patients with T2DM, particularly among younger and non-obese populations.