Association between Zhejiang University index and metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes mellitus

Table 1 Comparison of baseline clinical characteristics in type 2 diabetes mellitus patients grouped according to metabolic dysfunction-associated steatotic liver disease status, mean ± SD/n (%)

Variables	Total (n = 688)	Non-MASLD (n = 345)	MASLD (n = 343)	P value
Age (years)	56.71 ± 12.73	59.97 ± 11.9	53.44 ± 12.72	< 0.001
BMI (kg/m2)	25.16 ± 3.64	23.88 ± 3.21	26.45 ± 3.59	< 0.001
SBP (mmHg)	129.38 ± 18.11	128.11 ± 18.75	130.66 ± 17.37	0.064
DBP (mmHg)	78.37 ± 11.56	75.43 ± 11.1	81.33 ± 11.27	< 0.001
HbA1c (%)	9.10 ± 2.29	9.08 ± 2.50	9.12 ± 2.06	0.835
WBC (× 109/L)	6.35 ± 1.71	6.11 ± 1.55	6.60 ± 1.82	< 0.001
RBC (× 1012/L), median (Q1, Q3)	4.57 (4.22, 4.94)	4.46 (4.09, 4.85)	4.70 (4.35, 5.03)	0.291
PLT (× 109/L)	190.45 ± 56.48	186.71 ± 61.13	194.20 ± 51.19	0.083
TP (g/L)	65.23 ± 5.62	64.75 ± 5.53	65.72 ± 5.68	0.024
ALT (U/L)	29.08 ± 30.09	23.61 ± 29.12	34.59 ± 30.09	< 0.001
AST (U/L)	24.99 ± 23.85	22.13 ± 16.25	27.87 ± 29.34	0.002
BUN (mmol/L)	6.69 ± 2.35	7.13 ± 2.4	6.24 ± 2.21	< 0.001
TC (mmol/L)	4.72 ± 1.44	4.57 ± 1.47	4.87 ± 1.39	0.007
TG (mmol/L)	2.33 ± 2.68	1.76 ± 1.67	2.91 ± 3.31	< 0.001
HDL-C (mmol/L)	1.10 ± 0.32	1.14 ± 0.27	1.06 ± 0.35	< 0.001
LDL-C (mmol/L)	2.82 ± 0.93	2.71 ± 0.88	2.93 ± 0.97	0.003
FBG (mmol/L)	8.51 ± 3.87	8.48 ± 4.41	8.53 ± 3.24	0.863
ZJU index	40.07 ± 7.03	37.88 ± 6.67	42.27 ± 6.7	< 0.001
Scr (mmol/L)	61.00 (49, 72)	61.00 (50, 75)	60.00 (49, 70)	0.143
UA (mmol/L), median (Q1, Q3)	326.00 (267.5, 386)	310.00 (255, 372)	346.00 (284, 409.5)	< 0.001
Sex (male)	458 (66.57)	221 (64.06)	237 (69.1)	0.161
Smoking	254 (36.92)	120 (34.78)	134 (39.07)	0.244
Drinking	272 (39.53)	115 (33.33)	157 (45.77)	< 0.001
Hypertension	360 (52.33)	172 (49.86)	188 (54.81)	0.193
CAD	71 (10.32)	46 (13.33)	25 (7.29)	0.009

MASLD: Metabolic dysfunction-associated steatotic liver disease; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; HbA1c: Glycated hemoglobin; WBC: White blood cell count; RBC: Red blood cell count; PLT: Platelet; TP: Total protein; ALT: Alanine aminotransferase; AST: Aspartate transaminase; BUN: Blood urea nitrogen; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; FBG: Fasting blood glucose; ZJU: Zhejiang University; Scr: Serum creatinine; UA: Uric acid; CAD: Coronary artery disease.

Table 2 Univariate logistic regression analysis of metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients

Variables	β	SE	Z	P value	OR (95%CI)
Sex (female)	-0.23	0.16	-1.4	0.162	0.80 (0.58-1.10)
Smoking	0.18	0.16	1.16	0.244	1.20 (0.88-1.64)
Drinking	0.52	0.16	3.33	< 0.001	1.69 (1.24-2.30)
Hypertension	0.2	0.15	1.3	0.193	1.22 (0.90-1.65)
CAD	-0.67	0.26	-2.57	0.01	0.51 (0.31-0.85)
Age (years)	-0.04	0.01	-6.49	< 0.001	0.96 (0.95-0.97)
BMI (kg/m2)	0.24	0.03	8.58	< 0.001	1.27 (1.20-1.34)
SBP (mmHg)	0.01	0	1.85	0.064	1.01 (1.00-1.02)
DBP (mmHg)	0.05	0.01	6.46	< 0.001	1.05 (1.03-1.07)
HbA1c (%)	0.01	0.03	0.21	0.834	1.01 (0.94-1.08)
WBC (× 109/L)	0.18	0.05	3.64	< 0.001	1.20 (1.09-1.32)
RBC (× 1012/L)	-0.01	0.02	-0.91	0.361	0.99 (0.95-1.02)
PLT (× 109/L)	0	0	1.73	0.084	1.00 (1.00-1.01)
TP (g/L)	0.03	0.01	2.25	0.024	1.03 (1.01-1.06)
ALT (U/L)	0.02	0	4.69	< 0.001	1.02 (1.01-1.03)
AST (U/L)	0.02	0.01	3.03	0.002	1.02 (1.01-1.03)
BUN (mmol/L)	-0.19	0.04	-4.86	< 0.001	0.83 (0.77-0.89)
Scr (mmol/L)	0	0	-1.15	0.25	1.00 (0.99-1.00)
UA (mmol/L)	0.01	0	4.74	< 0.001	1.01 (1.01-1.01)
TC (mmol/L)	0.16	0.06	2.65	0.008	1.17 (1.04-1.32)
TG (mmol/L)	0.3	0.05	5.55	< 0.001	1.35 (1.21-1.49)
HDL-C (mmol/L)	-1.02	0.29	-3.52	< 0.001	0.36 (0.20-0.64)
LDL-C (mmol/L)	0.25	0.08	2.96	0.003	1.28 (1.09-1.52)
FBG (mmol/L)	0	0.02	0.17	0.863	1.00 (0.97-1.04)
ZJU index	0.11	0.01	7.78	< 0.001	1.11 (1.08-1.14)

CAD: Coronary artery disease; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; HbA1c: Glycated hemoglobin; WBC: White blood cell count; RBC: Red blood cell count; PLT: Platelet; TP: Total protein; ALT: Alanine aminotransferase; AST: Aspartate transaminase; BUN: Blood urea nitrogen; Scr: Serum creatinine; UA: Uric acid; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; FBG: Fasting blood glucose; ZJU: Zhejiang University; OR: Odds ratio; CI: Confidence interval.

Table 3 Multivariate logistic regression analysis of the relationship between Zhejiang University index and metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients

Variables	β	SE	Z	P value	OR (95%CI)
Model 1	0.11	0.01	7.78	< 0.001	1.11 (1.08-1.14)
Model 2	0.10	0.01	7.38	< 0.001	1.11 (1.08-1.14)
Model 3	0.07	0.02	4.56	< 0.001	1.07 (1.04-1.11)
Model 4	0.07	0.02	4.36	< 0.001	1.07 (1.04-1.11)

OR: Odds ratio; CI: Confidence interval.

Table 4 Comparison of baseline clinical characteristics in type 2 diabetes mellitus patients grouped according to Zhejiang University index, mean ± SD/n (%)

Variables	Low ZJU (n = 343)	High ZJU (n = 345)	P value
Age (years)	59.99 ± 10.71	53.44 ± 13.72	< 0.001
BMI (kg/m2)	23.29 ± 2.48	27.02 ± 3.66	< 0.001
SBP (mmHg)	127.95 ± 18.00	130.80 ± 18.13	0.039
DBP (mmHg)	75.46 ± 10.73	81.26 ± 11.64	< 0.001
HbA1c (%)	8.41 ± 2.08	9.78 ± 2.29	< 0.001
WBC (× 109/L)	6.14 ± 1.59	6.57 ± 1.79	< 0.001
RBC (× 1012/L)	4.91 ± 7.70	5.01 ± 6.57	0.864
PLT (× 109/L)	185.45 ± 57.16	195.39 ± 55.44	0.021
TP (g/L)	63.83 ± 5.33	66.62 ± 5.56	< 0.001
ALT (U/L)	21.01 ± 14.64	37.10 ± 38.29	< 0.001
AST (U/L)	22.46 ± 24.97	27.51 ± 22.44	0.005
BUN (mmol/L)	6.84 ± 2.17	6.53 ± 2.51	0.078
Scr (mmol/L)	67.52 ± 36.89	67.74 ± 48.46	0.947
UA (mmol/L)	317.97 ± 83.05	353.39 ± 104.97	< 0.001
TC (mmol/L)	4.30 ± 1.09	5.13 ± 1.61	< 0.001
TG (mmol/L)	1.40 ± 0.97	3.25 ± 3.41	< 0.001
HDL-C (mmol/L)	1.12 ± 0.27	1.08 ± 0.35	0.04
LDL-C (mmol/L)	2.60 ± 0.84	3.04 ± 0.96	< 0.001
FBG (mmol/L)	6.56 ± 1.95	10.44 ± 4.31	< 0.001
Sex (male)	240 (69.97)	218 (63.19)	0.059
Smoking	120 (34.99)	134 (38.84)	0.295
Drinking	116 (33.82)	156 (45.22)	0.002
Hypertension	182 (53.06)	178 (51.59)	0.7
CAD	49 (14.29)	22 (6.38)	< 0.001
MASLD	123 (35.86)	220 (63.77)	< 0.001

BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; HbA1c: Glycated hemoglobin; WBC: White blood cell count; RBC: Red blood cell count; PLT: Platelet count; TP: Total protein; ALT: Alanine aminotransferase; AST: Aspartate transaminase; BUN: Blood urea nitrogen; Scr: Serum creatinine; UA: Uric acid; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; FBG: Fasting blood glucose; CAD: Coronary artery disease; ZJU: Zhejiang University; MASLD: Metabolic dysfunction-associated steatotic liver disease.

Table 5 Univariate logistic regression analysis of Zhejiang University index in type 2 diabetes mellitus patients

Variables	β	SE	Z	P value	OR (95%CI)
Sex (female)	0.31	0.16	1.88	0.06	1.36 (0.99-1.87)
Smoking	0.17	0.16	1.05	0.295	1.18 (0.87-1.61)
Drinking	0.48	0.16	3.05	0.002	1.62 (1.19-2.20)
Hypertension	-0.06	0.15	-0.39	0.7	0.94 (0.70-1.27)
CAD	-0.89	0.27	-3.33	< 0.001	0.41 (0.24-0.69)
MASLD	1.15	0.16	7.22	< 0.001	3.15 (2.31-4.30)
Age (years)	-0.04	0.01	-6.52	< 0.001	0.96 (0.94-0.97)
BMI (kg/m2)	0.46	0.04	11.61	< 0.001	1.58 (1.46-1.71)
SBP (mmHg)	0.01	0	2.06	0.039	1.01 (1.01-1.02)
DBP (mmHg)	0.05	0.01	6.35	< 0.001	1.05 (1.03-1.06)
HbA1c (%)	0.29	0.04	7.47	< 0.001	1.34 (1.24-1.45)
WBC (× 109/L)	0.16	0.05	3.24	0.001	1.17 (1.06-1.29)
RBC (× 1012/L)	0	0.01	0.17	0.864	1.00 (0.98-1.02)
PLT (× 109/L)	0.01	0	2.29	0.022	1.01 (1.01-1.01)
TP (g/L)	0.09	0.02	6.32	< 0.001	1.10 (1.07-1.13)
ALT (U/L)	0.04	0.01	6.85	< 0.001	1.04 (1.03-1.05)
AST (U/L)	0.01	0.01	2.63	0.008	1.01 (1.01-1.02)
BUN (mmol/L)	-0.06	0.03	-1.74	0.081	0.94 (0.88-1.01)
Scr (mmol/L)	0	0	0.07	0.947	1.00 (1.00-1.00)
UA (mmol/L)	0.01	0	4.71	< 0.001	1.01 (1.01-1.01)
TC (mmol/L)	0.57	0.07	7.72	< 0.001	1.77 (1.53-2.05)
TG (mmol/L)	0.92	0.1	9.6	< 0.001	2.51 (2.08-3.03)
HDL-C (mmol/L)	-0.54	0.27	-2.01	0.045	0.58 (0.34-0.99)
LDL-C (mmol/L)	0.56	0.09	6.06	< 0.001	1.74 (1.46-2.09)
FBG (mmol/L)	0.53	0.04	11.92	< 0.001	1.70 (1.56-1.86)

CAD: Coronary artery disease; MASLD: Metabolic dysfunction-associated steatotic liver disease; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; HbA1c: Glycated hemoglobin; WBC: White blood cell count; RBC: Red blood cell count; PLT: Platelet; TP: Total protein; ALT: Alanine aminotransferase; AST: Aspartate transaminase; BUN: Blood urea nitrogen; Scr: Serum creatinine; UA: Uric acid; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; FBG: Fasting blood glucose; OR: Odds ratio; CI: Confidence interval.

Table 6 Multivariate logistic regression analysis of the relationship between the Zhejiang University index and metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients based on Zhejiang University subgroups

Variables	β	SE	Z	P value	OR (95%CI)
Model 1	1.15	0.16	7.22	< 0.001	3.15 (2.31-4.30)
Model 2	1.11	0.16	6.79	< 0.001	3.05 (2.21-4.20)
Model 3	0.79	0.18	4.32	< 0.001	2.21 (1.54-3.16)
Model 4	0.64	0.2	3.27	< 0.001	1.89 (1.29-2.78)

OR: Odds ratio; CI: Confidence interval.