Association between estimated glucose disposal rate and metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients

doi:10.4239/wjd.125355

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Diabetes. Oct 15, 2026; 17(10): 125355
Published online Oct 15, 2026. doi: 10.4239/wjd.125355

Table 1 Comparison of baseline clinical characteristics in type 2 diabetes mellitus patients, n (%)/mean ± SD

Variables	Total (n = 648)	Non-MASLD (n = 380)	MASLD (n = 260)	P value
Age (year)	57.19 ± 13.07	60.68 ± 11.79	52.25 ± 13.23	< 0.001
Duration (year)	5.00 (2.00, 14.00)	8.00 (2.75, 15.00)	3.00 (1.00, 9.25)	< 0.001
SBP (mmHg)	139.68 ± 18.44	139.37 ± 19.41	140.10 ± 16.98	0.611
DBP (mmHg)	82.89 ± 12.36	80.77 ± 11.96	85.88 ± 12.31	< 0.001
BMI (kg/m²)	26.41 ± 4.51	25.11 ± 3.76	28.26 ± 4.84	< 0.001
WC (cm)	96.44 ± 12.15	93.33 ± 11.16	100.85 ± 12.16	< 0.001
HC (cm)	102.25 ± 10.28	99.88 ± 8.95	105.60 ± 11.09	< 0.001
LDL-C (mmol/L)	3.09 ± 0.94	3.03 ± 0.92	3.19 ± 0.96	0.034
HDL-C (mmol/L)	1.23 ± 0.30	1.26 ± 0.29	1.19 ± 0.31	0.003
TG (mmol/L)	2.20 ± 2.65	1.81 ± 2.28	2.74 ± 3.03	< 0.001
TC (mmol/L)	4.95 ± 1.38	4.80 ± 1.29	5.17 ± 1.48	0.001
ALT (U/L)	23.00 (16.00, 35.00)	19.00 (14.00, 28.25)	29.00 (20.00, 45.00)	< 0.001
AST (U/L)	19.00 (15.00, 26.00)	17.00 (14.00, 22.00)	22.00 (17.00, 33.00)	< 0.001
FBG (mmol/L)	9.37 ± 3.36	9.14 ± 3.51	9.69 ± 3.11	0.043
HbA1c (%)	8.64 ± 2.06	8.58 ± 2.17	8.73 ± 1.89	0.367
BUN (mmol/L)	5.69 ± 2.44	5.77 ± 2.08	5.56 ± 2.87	0.273
UA (mmol/L)	341.55 ± 101.79	325.64 ± 95.85	364.10 ± 105.81	< 0.001
Scr (mmol/L)	64.88 ± 24.26	65.53 ± 25.09	63.96 ± 23.05	0.416
Hcy (μmol/L)	14.17 ± 7.35	13.74 ± 6.23	14.76 ± 8.67	0.082
RBC (× 10¹²/L)	4.66 ± 0.58	4.56 ± 0.59	4.80 ± 0.52	< 0.001
Hb (g/L)	142.18 ± 19.37	138.74 ± 19.37	147.05 ± 18.32	< 0.001
WBC (× 10⁹/L)	6.20 ± 1.86	5.98 ± 1.69	6.51 ± 2.04	< 0.001
PLT (× 10⁹/L)	224.57 ± 60.02	218.11 ± 58.58	233.73 ± 60.95	0.001
eGDR	5.85 ± 2.46	6.30 ± 2.43	5.21 ± 2.36	< 0.001
Sex	-	-	-	0.025
Male	375 (57.87)	206 (54.21)	169 (63.06)	-
Female	273 (42.13)	174 (45.79)	99 (36.94)	-
Smoking	-	-	-	0.362
No	200 (30.86)	112 (29.47)	88 (32.84)	-
Yes	448 (69.14)	268 (70.53)	180 (67.16)	-
HT	-	-	-	0.030
No	289 (44.60)	183 (48.16)	106 (39.55)	-
Yes	359 (55.40)	197 (51.84)	162 (60.45)	-
eGDR quantile	-	-	-	< 0.001
Q1	162 (25.00)	65 (17.11)	97 (36.19)	-
Q2	162 (25.00)	99 (26.05)	63 (23.51)	-
Q3	162 (25.00)	101 (26.58)	61 (22.76)	-
Q4	162 (25.00)	115 (30.26)	47 (17.54)	-

BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; WC: Waist circumference; HC: Hip circumference; HbA1c: Glycated hemoglobin; 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; ALT: Alanine aminotransferase; AST: Aspartate transaminase; Hcy: Homocysteine; RBC: Red blood cell; WBC: White blood cell; Hb: Hemoglobin; PLT: Platelet; HT: Hypertension; eGDR: Estimated glucose disposal rate; MASLD: Metabolic dysfunction-associated steatotic liver disease.

Full Size Table

Table 2 Participants demographics and baseline characteristics based on estimated glucose disposal rate quartiles, n (%)/mean ± SD

Variables	eGDR				P value
Variables	Q1 (n = 162)	Q2 (n = 162)	Q3 (n = 162)	Q4 (n = 162)	P value
Age (year)	52.25 ± 15.49	58.86 ± 13.21	57.45 ± 11.48	60.21 ± 10.21	< 0.001
Duration (year)	4.00 (1.00, 10.00)	7.00 (2.00, 15.00)	5.50 (2.00, 13.00)	6.00 (2.00, 15.00)	0.037
SBP (mmHg)	150.88 ± 16.04	150.08 ± 16.30	132.93 ± 14.44	124.81 ± 11.46	< 0.001
DBP (mmHg)	90.60 ± 11.91	87.71 ± 11.35	79.20 ± 9.97	74.03 ± 8.23	< 0.001
BMI (kg/m²)	29.63 ± 5.28	25.94 ± 3.96	25.62 ± 3.61	24.47 ± 3.18	< 0.001
WC (cm)	106.49 ± 12.00	96.27 ± 8.17	94.59 ± 9.33	88.38 ± 11.20	< 0.001
HC (cm)	110.04 ± 11.10	101.49 ± 7.03	100.34 ± 8.57	97.11 ± 9.31	< 0.001
LDL-C (mmol/L)	3.38 ± 1.01	3.01 ± 0.92	3.05 ± 0.86	2.93 ± 0.92	< 0.001
HDL-C (mmol/L)	1.16 ± 0.27	1.25 ± 0.31	1.24 ± 0.31	1.26 ± 0.30	0.017
TG (mmol/L)	2.42 ± 1.95	2.24 ± 2.43	2.27 ± 3.15	1.87 ± 2.91	0.284
TC (mmol/L)	5.30 ± 1.46	4.92 ± 1.29	4.88 ± 1.38	4.71 ± 1.33	0.001
ALT (U/L)	32.50 (19.00, 47.75)	23.00 (16.00, 34.00)	21.00 (16.00, 29.75)	20.00 (14.00, 29.00)	< 0.001
AST (U/L)	23.00 (16.00, 36.00)	19.00 (15.25, 25.00)	18.00 (16.00, 23.00)	18.00 (16.00, 22.00)	< 0.001
FBG (mmol/L)	10.60 ± 3.48	9.31 ± 3.75	9.30 ± 3.08	8.27 ± 2.63	< 0.001
HbA1c (%)	9.95 ± 2.00	8.30 ± 1.90	8.81 ± 2.13	7.49 ± 1.30	< 0.001
BUN (mmol/L)	5.59 ± 3.20	6.01 ± 2.43	5.56 ± 2.31	5.59 ± 1.54	0.290
UA (mmol/L)	362.64 ± 107.67	344.64 ± 109.19	339.48 ± 98.40	319.43 ± 86.51	0.002
Scr (mmol/L)	65.30 ± 22.30	67.12 ± 27.16	64.83 ± 28.95	62.27 ± 16.73	0.348
Hcy (μmol/L)	15.53 ± 7.85	14.57 ± 8.32	13.17 ± 5.16	13.38 ± 7.48	0.012
RBC (× 10¹²/L)	4.87 ± 0.57	4.60 ± 0.60	4.66 ± 0.58	4.51 ± 0.49	< 0.001
Hb (g/L)	146.17 ± 18.78	141.71 ± 19.06	144.20 ± 20.91	136.62 ± 17.41	< 0.001
WBC (× 10⁹/L)	6.69 ± 2.04	6.38 ± 2.22	5.91 ± 1.46	5.82 ± 1.49	< 0.001
PLT (× 10⁹/L)	230.90 ± 67.82	224.08 ± 59.20	220.48 ± 57.95	222.81 ± 54.36	0.440
eGDR	2.83 ± 0.94	4.81 ± 0.39	6.69 ± 0.72	9.07 ± 1.14	< 0.001
Sex	-	-	-	-	< 0.001
Male	106 (65.43)	97 (59.88)	102 (62.96)	70 (43.21)	-
Female	56 (34.57)	65 (40.12)	60 (37.04)	92 (56.79)	-
Smoking	-	-	-	-	0.153
No	50 (30.86)	55 (33.95)	56 (34.57)	39 (24.07)	-
Yes	112 (69.14)	107 (66.05)	106 (65.43)	123 (75.93)	-
HT	-	-	-	-	< 0.001
No	7 (4.32)	14 (8.64)	110 (67.90)	158 (97.53)	-
Yes	155 (95.68)	148 (91.36)	52 (32.10)	4 (2.47)	-
MASLD	-	-	-	-	< 0.001
No	65 (40.12)	99 (61.11)	101 (62.35)	115 (70.99)	-
Yes	97 (59.88)	63 (38.89)	61 (37.65)	47 (29.01)	-

Full Size Table

Table 3 Multivariate logistic regression analyses of estimated glucose disposal rate and metabolic dysfunction-associated steatotic liver disease

Variables	Model 1		Model 2		Model 3		Model 4
Variables	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
eGDR
Q1	1.00 (reference)	-	1.00 (reference)	-	1.00 (reference)	-	1.00 (reference)
Q2	0.43 (0.27-0.67)	< 0.001	0.46 (0.29-0.73)	0.016	0.50 (0.31-0.81)	0.004	0.56 (0.35-0.92)	0.021
Q3	0.40 (0.26-0.63)	< 0.001	0.41 (0.26-0.66)	< 0.001	0.45 (0.28-0.72)	< 0.001	0.54 (0.33-0.88)	< 0.013
Q4	0.27 (0.17-0.43)	< 0.001	0.29 (0.18-0.47)	< 0.001	0.33 (0.20-0.55)	< 0.001	0.42 (0.25-0.70)	< 0.001

Model 1 crude; Model 2 adjust: Sex, duration and age; Model 3 adjust: Sex, duration, age, total cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol; Model 4: Adjust: Sex, duration, age, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, alanine aminotransferase, aspartate transaminase, blood urea nitrogen, serum creatinine, uric acid, homocysteine, white blood cell, and platelet. OR: Odds ratio; CI: Confidence interval; eGDR: Estimated glucose disposal rate.

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Table 4 Subgroup analyses of the association between estimated glucose disposal rate and metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients

Variables	n (%)	OR (95%CI)	P value	P for interaction
All patients	648 (100.00)	0.83 (0.77-0.89)	< 0.001	-
Gender	-	-	-	0.042
Male	375 (57.87)	0.78 (0.71-0.86)	< 0.001	-
Female	273 (42.13)	0.90 (0.81-1.00)	0.049	-
Smoking	-	-	-	0.837
No	200 (30.86)	0.82 (0.72-0.93)	0.003	-
Yes	448 (69.14)	0.83 (0.77-0.90)	< 0.001	-
HT	-	-	-	0.126
No	289 (44.60)	0.78 (0.67-0.91)	0.002	-
Yes	359 (55.40)	0.66 (0.56-0.77)	< 0.001	-
Age	-	-	-	0.721
< 45	119 (18.36)	0.82 (0.68-0.99)	0.038	-
45-60	224 (34.57)	0.86 (0.77-0.96)	0.010	-
≥ 60	305 (47.07)	0.89 (0.80-0.99)	0.040	-
Duration	-	-	-	0.892
< 5	289 (44.60)	0.82 (0.74-0.90)	< 0.001	-
5-10	122 (18.83)	0.83 (0.71-0.97)	0.018	-
≥ 10	237 (36.57)	0.85 (0.75-0.97)	0.013	-
BMI	-	-	-	0.682
< 24	255 (39.41)	0.87 (0.77-0.99)	0.032	-
24-28	189 (29.21)	0.89 (0.77-1.02)	0.092	-
≥ 28	203 (31.38)	0.94 (0.83-1.06)	0.328	-

OR: Odds ratio; CI: Confidence interval; HT: Hypertension; BMI: Body mass index.

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Table 5 Comparison of baseline clinical characteristics stratified by gender, n (%)/mean ± SD

Variables	Male			Female
Variables	Non-MASLD (n = 206)	MASLD (n = 169)	P value	Non-MASLD (n = 174)	MASLD (n = 99)	P value
Age (year)	58.59 ± 12.31	49.11 ± 12.97	< 0.001	63.15 ± 10.65	57.63 ± 11.93	< 0.001
Duration (year)	6.00 (2.25, 15.00)	3.00 (1.00, 8.00)	< 0.001	10.00 (3.00, 17.00)	4.00 (2.00, 10.00)	< 0.001
SBP (mmHg)	137.60 ± 18.35	139.93 ± 14.87	0.174	141.48 ± 20.46	140.39 ± 20.16	0.673
DBP (mmHg)	83.88 ± 12.12	87.84 ± 11.20	0.001	77.10 ± 10.70	82.54 ± 13.42	< 0.001
BMI (kg/m²)	25.34 ± 3.86	28.67 ± 4.97	< 0.001	24.85 ± 3.63	27.55 ± 4.55	< 0.001
WC (cm)	95.80 ± 9.45	103.93 ± 11.79	< 0.001	90.43 ± 12.28	95.59 ± 10.96	< 0.001
HC (cm)	100.95 ± 8.14	107.25 ± 10.77	< 0.001	98.63 ± 9.70	102.79 ± 11.10	0.001
LDL-C (mmol/L)	2.96 ± 0.90	3.16 ± 0.93	0.038	3.11 ± 0.95	3.23 ± 1.01	0.299
HDL-C (mmol/L)	1.19 ± 0.28	1.15 ± 0.31	0.200	1.33 ± 0.29	1.24 ± 0.29	0.016
TG (mmol/L)	2.03 ± 2.68	3.12 ± 3.60	0.001	1.56 ± 1.66	2.09 ± 1.43	0.008
TC (mmol/L)	4.72 ± 1.28	5.18 ± 1.53	0.002	4.90 ± 1.31	5.15 ± 1.40	0.143
ALT (U/L)	20.00 (15.00, 27.00)	29.00 (21.00, 46.00)	< 0.001	18.00 (13.00, 29.00)	28.00 (18.50, 42.00)	< 0.001
AST (U/L)	17.00 (14.00, 21.00)	22.00 (17.00, 32.00)	< 0.001	18.00 (14.00, 23.00)	22.00 (16.00, 36.50)	< 0.001
FBG (mmol/L)	9.15 ± 3.33	9.92 ± 3.29	0.025	9.14 ± 3.73	9.28 ± 2.73	0.737
HbA1c (%)	8.60 ± 2.29	8.75 ± 1.86	0.488	8.55 ± 2.02	8.68 ± 1.95	0.605
BUN (mmol/L)	6.17 ± 2.17	5.69 ± 3.41	0.104	5.31 ± 1.87	5.33 ± 1.56	0.912
UA (mmol/L)	350.02 ± 97.94	386.92 ± 104.17	< 0.001	296.78 ± 84.93	325.13 ± 97.32	0.013
Scr (mmol/L)	71.85 ± 25.51	67.20 ± 13.64	0.033	58.05 ± 22.45	58.41 ± 32.85	0.913
Hcy (μmol/L)	14.96 ± 6.32	16.03 ± 8.10	0.153	12.30 ± 5.82	12.61 ± 9.22	0.737
RBC (× 10¹²/L)	4.80 ± 0.56	4.98 ± 0.51	0.001	4.28 ± 0.50	4.51 ± 0.40	< 0.001
Hb (g/L)	147.66 ± 16.79	154.50 ± 16.42	< 0.001	128.18 ± 16.78	134.32 ± 13.88	0.002
WBC (× 10⁹/L)	6.05 ± 1.63	6.57 ± 2.11	0.007	5.91 ± 1.77	6.39 ± 1.93	0.037
PLT (× 10⁹/L)	207.93 ± 54.88	229.49 ± 59.17	< 0.001	230.16 ± 60.66	240.97 ± 63.53	0.165
Smoking	-	-	0.782	-	-	1.000
No	109 (52.91)	87 (51.48)	-	171 (98.28)	98 (98.99)	-
Yes	97 (47.09)	82 (48.52)	-	3 (1.72)	1 (1.01)	-
HT	-	-	0.015	-	-	0.721
No	100 (48.54)	61 (36.09)	-	83 (47.70)	45 (45.45)	-
Yes	106 (51.46)	108 (63.91)	-	91 (52.30)	54 (54.55)	-
eGDR quantile	-	-	< 0.001	-	-	0.412
Q1	31 (15.05)	63 (37.28)	-	38 (21.84)	30 (30.30)	-
Q2	55 (26.70)	38 (22.49)	-	43 (24.71)	25 (25.25)	-
Q3	54 (26.21)	40 (23.67)	-	45 (25.86)	22 (22.22)	-
Q4	66 (32.04)	28 (16.57)	-	48 (27.59)	22 (22.22)	-

Full Size Table

Table 6 Multivariate logistic regression analyses of estimated glucose disposal rate and metabolic dysfunction-associated steatotic liver disease stratified by gender

Variables		Model 1		Model 2		Model 3		Model 4
Variables		OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Male	eGDR
	Q1	1.00 (reference)	-	1.00 (reference)	-	1.00 (reference)	-	1.00 (reference)	-
	Q2	0.34 (0.19-0.62)	< 0.001	0.34 (0.19-0.62)	< 0.001	0.37 (0.20-0.70)	0.002	0.42 (0.22-0.81)	0.009
	Q3	0.36 (0.20-0.66)	< 0.001	0.36 (0.20-0.66)	< 0.001	0.41 (0.22-0.77)	0.006	0.44 (0.23-0.84)	0.013
	Q4	0.21 (0.11-0.39)	< 0.001	0.21 (0.11-0.39)	< 0.001	0.24 (0.12-0.45)	< 0.001	0.27 (0.14-0.51)	< 0.001
Female	eGDR
	Q1	1.00 (reference)	-	1.00 (reference)	-	1.00 (reference)	-	1.00 (reference)	-
	Q2	0.74 (0.37-1.46)	0.383	0.68 (0.33-1.42)	0.307	0.76 (0.36-1.60)	0.471	0.81 (0.37-1.74)	0.583
	Q3	0.62 (0.31-1.25)	0.179	0.47 (0.23-0.99)	0.050	0.51 (0.24-1.09)	0.084	0.56 (0.25-1.23)	0.147
	Q4	0.58 (0.29-1.16)	0.125	0.50 (0.24-1.04)	0.064	0.60 (0.28-1.29)	0.191	0.71 (0.32-1.58)	0.401

Model 1 crude; Model 2 adjust: Sex, duration and age; Model 3 adjust: Sex, duration, age, TC, TG, LDL-C and HDL-C; Model 4: Adjust: Sex, duration, age, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, alanine aminotransferase, aspartate transaminase, blood urea nitrogen, serum creatinine, uric acid, homocysteine, white blood cell, and platelet. OR: Odds ratio; CI: Confidence interval; eGDR: Estimated glucose disposal rate.

Full Size Table

Citation: Yin JT, Lu YX, Li ZM, Niu S. Association between estimated glucose disposal rate and metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus patients. World J Diabetes 2026; 17(10): 125355
URL: https://www.wjgnet.com/1948-9358/full/v17/i10/125355.htm
DOI: https://dx.doi.org/10.4239/wjd.125355