Zhang M, Yu MG, Shen XN, Kang GB. Zhejiang University index predicts metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients. World J Diabetes 2025; 16(12): 114565 [DOI: 10.4239/wjd.v16.i12.114565]
Corresponding Author of This Article
Guo-Bin Kang, Academic Fellow, Department of Cardiology I, Hebei Provincial Hospital of Chinese Medicine, The First Affiliated Hospital of Hebei University of Chinese Medicine, No. 389 Zhongshan East Road, Shijiazhuang 050000, Hebei, China. kanggb1229@126.com
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Dec 15, 2025 (publication date) through Dec 15, 2025
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World Journal of Diabetes
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Zhang M, Yu MG, Shen XN, Kang GB. Zhejiang University index predicts metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients. World J Diabetes 2025; 16(12): 114565 [DOI: 10.4239/wjd.v16.i12.114565]
World J Diabetes. Dec 15, 2025; 16(12): 114565 Published online Dec 15, 2025. doi: 10.4239/wjd.v16.i12.114565
Zhejiang University index predicts metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients
Man Zhang, Miao-Guang Yu, Xiang-Nan Shen, Guo-Bin Kang
Man Zhang, Guo-Bin Kang, Department of Cardiology I, Hebei Provincial Hospital of Chinese Medicine, The First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang 050000, Hebei Province, China
Miao-Guang Yu, Department of Acupuncture and Moxibustion, Tianjin Ninghe District Hospital of Traditional Chinese Medicine, Tianjin 301509, China
Xiang-Nan Shen, Department of Orthopedics II, Hebei Provincial Hospital of Chinese Medicine, The First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang 050000, Hebei Province, China
Author contributions: Zhang M critically evaluated the review article and edited the manuscript accordingly; Yu MG and Shen XN were responsible for examining pertinent literature and organizing the arguments to substantiate the line of inquiry; Kang GB is responsible for refining the academic language, harmonizing the author's viewpoints, and facilitating communication with the editorial team; all authors collectively examined and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Bin Kang, Academic Fellow, Department of Cardiology I, Hebei Provincial Hospital of Chinese Medicine, The First Affiliated Hospital of Hebei University of Chinese Medicine, No. 389 Zhongshan East Road, Shijiazhuang 050000, Hebei, China. kanggb1229@126.com
Received: September 26, 2025 Revised: October 30, 2025 Accepted: November 12, 2025 Published online: December 15, 2025 Processing time: 80 Days and 20.2 Hours
Abstract
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.
Core Tip: This correspondence critically evaluates the study by Tao et al on the ability of the Zhejiang University index to predict metabolic dysfunction-associated steatotic liver disease (MASLD) in type 2 diabetes mellitus patients. It commends the index as it is a minimally invasive biomarker panel and methodologically sound but highlights several limitations, such as the reliance on a hospitalized patient sample, lack of information on pharmacological treatments, the inherent constraints of ultrasound imaging, and the cross-sectional nature of the study. The authors suggest that future research should aim at prospective validation in outpatient settings and exploring the underlying mechanisms of MASLD.
