Zhejiang University index predicts metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients

The Zhejiang University (ZJU) index, which combines body mass index, fasting blood glucose, triglyceride level and alanine aminotransferase/aspartate aminotransferase ratio, can be used to predict metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes mellitus (T2DM). The ZJU index of 38.87 has been identified as the key threshold for diagnosing MASLD. The new model for predicting MASLD in T2DM based on ZJU index shows high diagnostic value. While the study is methodologically robust and offers a valuable clinical tool, it is limited by its cross-sectional design, inpatient cohort bias, unadjusted pharmacotherapy effects, and reliance on ultrasound for MASLD diagnosis. Future validation in outpatient settings, incorporating medication data and advanced fibrosis assessment, is crucial to translate this cost-effective biomarker into wide practice.