Diagnostic Utility of Fibroscan in Detecting Subclinical Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) in Recently Diagnosed Type 2 Diabetes Mellitus in Eastern India

Abstract Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among patients with type 2 Diabetes Mellitus (T2DM) and may remain clinically silent despite progressive hepatic fibrosis. Early identification of subclinical liver involvement is therefore important in recently diagnosed T2DM patients. FibroScan provides a non-invasive assessment of hepatic steatosis and fibrosis. Aim To evaluate the diagnostic utility of FibroScan for detecting subclinical MASLD and significant hepatic fibrosis among recently diagnosed patients with T2DM. Materials and methods A prospective observational diagnostic study was conducted among 120 adults with recently diagnosed T2DM at a tertiary care government hospital in eastern India. Participants underwent clinical, anthropometric and biochemical assessment followed by FibroScan examination. Controlled attenuation parameter (CAP) was used to assess hepatic steatosis, while liver stiffness measurement (LSM) was used to evaluate hepatic fibrosis. Associations between MASLD and metabolic parameters were assessed, and diagnostic performance was evaluated using sensitivity, specificity and receiver operating characteristic (ROC) analysis. Result MASLD was detected in 86 (71.7%) participants, including mild, moderate and severe steatosis in 35.0%, 24.2% and 12.5%, respectively. Significant fibrosis was identified in 29 (24.2%) participants. MASLD was significantly associated with higher BMI (p < 0.001), HbA1c (p = 0.011), triglycerides (p < 0.001) and ALT (p = 0.001). FibroScan demonstrated 82.8% sensitivity, 85.7% specificity and 85.0% diagnostic accuracy for significant fibrosis, with an AUC of 0.88. CAP showed excellent discrimination for MASLD (AUC 0.91, p < 0.001). Conclusion FibroScan appears to be a useful non-invasive tool for early detection and risk stratification of MASLD and hepatic fibrosis in recently diagnosed T2DM patients.