SAT-536 How Do Metabolic Dysfunction Associated Steatosis Liver Disease (MASLD) and Depression in Veterans with T2DM respond to novel medications

Abstract Disclosure: S.D. Ubalde: None. J. Khoury: None. S. Sen: None. Background: In this project we wanted to explore the association between Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) and Depression in Veterans with Type-2 Diabetes Mellitus and whether the novel diabetes medications influence the MASLD and depression scores in veterans. We examined the following: Glucagon-like-peptide-1 receptor agonists (GLP-1A +/- insulin or metformin), Sodium-glucose cotransporter-2 inhibitors (SGLT2i +/- ins or met) and compared their effect with Metformin and/or Insulin group as control. Methods: We conducted a cross-sectional single-timepoint analysis of patient visits from the DC VAMC type 2 diabetes (T2DM) clinic over a period of 16 months. We have screened about 325 patient visits from which we analyzed 58 patient visits that had evidence of both depression and MASLD (ie: PHQ-9 score of >5 and FIB-4 score of >1.3). Results: Our study cohort was 95% male population with 79% of African American Veteran race with mean age of 71.16 years. Across the groups, the mean HbA1C was 7.955±0.19% with no significant differences across group. Overall BMI was 30.52±0.72 kg/m2. SGLT2i takers group had a slightly lower BMI of 27.85±1.0 kg/m2 compared to GLP1A group with 33.50±1.1 kg/m2(p=0.0016 using unpaired t-test). GLP-1A group showed a mean PHQ-9 score of 10.57±1.2 (n=14), SGLT2i group showed 11.16±1.2 (n=19) and Met/Ins group had 10.72±1.0 (n=25). There was no significant difference across groups though GLP1A group had a lower mean PHQ9 score. Next our MASLD analysis showed that SGLT2i group had a mean FIB-4 score of 2.382±0.31, GLP1A group had 1.945±0.14, Met/Ins group had 1.804±0.082. Again, though there was no significant difference across groups, SGLT2i group clearly had a higher mean FIB-4 score compared to the other groups. Subsequently, we analyzed GLP1A and SGLT2i groups to check for any correlation between depression scores and liver fibrosis scores. We used PHQ-9 as an independent variable and FIB-4 score as a dependent variable. Our correlation results showed GLP1A had minimal correlation between depression and MASLD with a linear regression of y=0.0009916x+1.840 (R2 = 0.007229), and SGLT2i group had a negative or no correlation with y=-0.07783x (R2 =0.09481) between the two common T2DM associated diseases. Conclusion: Our cohort consists mainly of African American men with T2DM. Interestingly the data on African Americans is limited. Though there was no significant difference amongst veterans on different medications for depression scores and MASLD, taking both scores into account, GLP1A seems to have favorable effect compared to SGLT2is for both depression and MASLD. This effect appears to be independent of weight or HbA1C. There were no significant correlations between depression and MASLD in either medication groups, negating any possible inter-dependency or relationship between these two co-morbidities in this population. Presentation: Saturday, July 12, 2025