Hepatic steatosis risk in nonobese Chinese adults with type 1 diabetes.

Metabolic dysfunction-associated steatotic liver disease (MASLD) may be an important comorbidity in nonobese Chinese adults with type 1 diabetes (T1D). We assessed the likelihood of hepatic steatosis using the hepatic steatosis index (HSI) in 47 nonobese Chinese adults with T1D (mean age 46.9 ± 14.1 years; BMI 22.6 ± 2.5 kg/m2) and examined its association with insulin requirements. Overall, 27.7% of participants had an HSI >36, indicating a high likelihood of MASLD. Compared with those with HSI <30 (low likelihood of MASLD), individuals with HSI >36 required higher bolus and total daily insulin doses, while achieving comparable glycemic profiles. These findings demonstrate that an HSI >36 is relatively common in nonobese Chinese adults with T1D and is associated with higher insulin requirements. MASLD may therefore represent an under-recognized but clinically relevant comorbidity in nonobese Chinese adults with T1D, warranting greater attention in screening and management strategies.