Serum biomarkers and non-invasive indices for discriminating MASLD among adults with dysglycaemia
Kübranur Ünal, Leyla İbrahimkhanlı, Mehmet Emre Erol, Sabri Engin Altıntop, Nemat İbrahimkhanlı, Halit Nahit Şendur, Mahi Nur Cerit, Ethem Turgay CeritAbstract
Objectives
Metabolic dysfunction–associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide. Although dysglycaemia is a major risk factor, additional cardiometabolic disturbances contribute to the development of MASLD. This study aimed to identify parameters that distinguish MASLD among dysglycaemic individuals using body composition, anthropometric, biochemical, and imaging-based assessments.
Methods
In this cross-sectional study, male and female adults were stratified into three groups: dysglycaemic individuals with MASLD (MASLD-Dys), dysglycaemic individuals without MASLD (Dys), and normoglycaemic individuals without MASLD as healthy controls. Imaging-based hepatic fat quantification, body composition, anthropometric and biochemical parameters, and non-invasive indices assessing hepatic steatosis and fibrosis were evaluated.
Results
Compared with Dys participants, MASLD-Dys participants had higher body mass index (BMI), waist circumference, trunk fat mass, ultrasound-derived hepatic fat fraction (USFF), and Fatty Liver Index (FLI). The strongest between-group separation was observed for USFF (p<0.001). In receiver operating characteristic analysis, USFF showed the highest discriminative performance for MASLD-Dys vs. Dys, with an area under the curve of 0.925 and an optimal cut-off of ≥6.95 %.
Conclusions
USFF was the strongest discriminator of MASLD among dysglycaemic adults, while FLI provided a practical non-imaging alternative. These findings support integrating hepatic fat quantification and body composition measures into MASLD risk stratification beyond glycaemic status alone.