Association between Glycemic Control and Hepatic Steatosis Severity in Type 2 Diabetic Patients

Abstract

Background: Hepatic steatosis is common among patients with type 2 diabetes mellitus and may worsen with poor glycemic control and metabolic dysfunction.

Objective: To assess the association between glycemic control and hepatic steatosis severity in patients with type 2 diabetes mellitus.

Methodology: This cross-sectional analytical study was conducted at Department of Medicine Unit-2, Chandka Medical College Hospital, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana from 1^st May 2025 to 31^st October 2025, including 240 patients with type 2 diabetes mellitus. Baseline demographic and clinical variables included age, gender, duration of diabetes, body mass index, blood pressure, smoking status, comorbidities including hypertension and dyslipidemia, and antidiabetic treatment history.

Results: Patients with moderate/severe steatosis were older, had longer diabetes duration, and higher body mass index compared with those having no/mild steatosis. HbA1c increased progressively from 6.8±0.9% in patients without steatosis to 10.1±1.6% in severe steatosis (p<0.001). Fasting blood glucose, alanine aminotransferase, aspartate aminotransferase, and triglycerides also increased significantly with steatosis severity. Hemoglobin A1c showed the strongest positive correlation with steatosis grade (r=0.68; p<0.001). Poor glycemic control was the strongest predictor of moderate-to-severe hepatic steatosis (aOR 4.26; 95% CI: 2.08–8.71; p<0.001).

Conclusion: Poor glycemic control is significantly associated with increased hepatic steatosis severity in type 2 diabetic patients.