From fatty liver indices to the Zhejiang University index: Re-shaping risk stratification of metabolic liver disease in diabetes

Core Tip

Core Tip: Early identification of metabolic dysfunction-associated steatotic liver disease (MASLD) in diabetes requires reliable and easily applicable tools. The Zhejiang University index (ZJU index) combines metabolic and hepatic parameters, such as body mass index, fasting glucose, triglycerides, and enzyme ratios, into a simple score derived from routine clinical data. Unlike traditional indices such as fatty liver index and hepatic steatosis index, the ZJU index demonstrates superior accuracy for detecting MASLD and correlates with systemic complications, including insulin resistance and sarcopenia. Its integration into electronic medical records enables automatic annual screening of patients with type 2 diabetes mellitus, providing a cost-effective, non-invasive approach for risk stratification and guiding timely preventive interventions.