Xiaoyan Tao, Tianrong Pan, Xing Zhong, Xiaoyu Pan
BACKGROUND: The Zhejiang University (ZJU) index has been demonstrated to have notable value in predicting metabolic dysfunction-associated steatotic liver disease (MASLD) within Chinese populations. However, the correlation between the ZJU index and MASLD in type 2 diabetes mellitus (T2DM) patients remains to be elucidated. AIM: To investigate the association between the ZJU index and MASLD among patients with T2DM. METHODS: This cross-sectional study was conducted on hospitalised patients diagnosed with T2DM. Anthropometric measurements, laboratory data, and ultrasound results were initially collected from all patients. The ZJU index was subsequently calculated. Regression analysis was then used to explore risk factors affecting MASLD, and the optimal ZJU index cut-off value for diagnosing MASLD was determined using restricted cubic spline analysis. Finally, a new model for predicting MASLD in T2DM patients based on the ZJU index was constructed. This model was based on the risk factors identified by regression analysis, and the area under curve values were calculated. The validity and reliability of the models were then compared with each other. RESULTS: A total of 688 patients with T2DM were included in this study. A significant positive correlation was identified between the ZJU index and the development of MASLD. Furthermore, the results of the restricted cubic spline analysis showed a non-linear association between ZJU index and MASLD. The ZJU value of 38.87 was identified as the key threshold for diagnosing MASLD. The new predictive model, which was developed by regression analysis, demonstrated a higher diagnostic value for MASLD and exhibited good accuracy in comparison with metabolic indices alone (area under curve = 0.76, 95% confidence interval: 0.72-0.80). CONCLUSION: The ZJU index has been shown to be linked to the risk of developing MASLD, and the new model constructed has been shown to possess good predictive value.