ArticleCureus2026
The Diabetic Catalyst: A Rapid 12-Month Evolution of Hepatic Stiffness in a South Indian Cohort With Metabolic Dysfunction-Associated Steatotic Liver Disease.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a significant clinical concern, particularly in populations where hepatic complications manifest at relatively low body mass index (BMI) thresholds. While type 2 diabetes mellitus (T2DM) is often associated with the progression of hepatic damage, there is a limited amount of prospective, longitudinal data comparing the specific rate of fibrosis development between diabetic and non-diabetic individuals in the South Indian clinical setting. This study aimed to monitor biochemical and radiological markers over a 12-month period to quantify the impact of T2DM on the temporal progression of hepatic fibrosis. Methods This prospective, longitudinal cohort study was conducted at a tertiary care academic hospital in South India from January to December 2024. A total of 126 participants with ultrasound-confirmed MASLD and a controlled attenuation parameter (CAP) >248 dB/m were initially enrolled. Following an attrition of 28 participants (22.2%) due to failure of follow-up, a final per-protocol analysis was conducted on 98 participants, divided into Group A (T2DM; n=49) and Group B (non-T2DM; n=49). Follow-up assessments were performed at baseline (M0), midpoint (M6), and endpoint (M12) using a double-look imaging strategy. Hepatic fat and stiffness were quantified using transient elastography (FibroScan®) to measure CAP and liver stiffness measurement (LSM), supplemented by the calculated Fibrosis-4 (FIB-4) index. Results At baseline, the diabetic cohort in Group A exhibited a significantly higher metabolic burden, including a higher mean BMI (27.2 ± 3.1 vs 25.1 ± 2.4 kg/m
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