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

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

Jian-Tong Yin, Yi-Xiao Lu, Zi-Meng Li, Shu Niu

Jian-Tong Yin, Yi-Xiao Lu, Zi-Meng Li, Department of Endocrinology, Hebei Medical University, Shijiazhuang 050011, Hebei Province, China

Jian-Tong Yin, Zi-Meng Li, Shu Niu, Department of Endocrinology, Shijiazhuang People’s Hospital, Shijiazhuang 050011, Hebei Province, China

Yi-Xiao Lu, Department of Endocrinology, The Fourth Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang 050011, Hebei Province, China

Author contributions: Yin JT and Niu S designed the research, performed data curation, formal analysis, and methodology development, as well as managed resources and utilized software, wrote the original draft of the manuscript; Lu YX and Li ZM reviewed and edited the manuscript to ensure its scientific rigor and clarity, contributing critical input in refining the final draft; and all authors thoroughly reviewed and endorsed the final manuscript.

AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.

Supported by 2024 Mandatory Research Projects of the Hebei Provincial Administration of Traditional Chinese Medicine, No. 2024127.

Institutional review board statement: This study was approved by the Medical Ethics Committee of Shijiazhuang People’s Hospital, approval No. 2024-177.

Informed consent statement: Written informed consent for publication was obtained from all patients and/or their families included in this study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The data sets generated and analyzed during this study are not public, but under reasonable requirements, the correspondence author can provide.

Corresponding author: Shu Niu, PhD, Department of Endocrinology, Shijiazhuang People’s Hospital, No. 36 Fanxi Road, Chang’an District, Shijiazhuang 050011, Hebei Province, China. niushu1007@126.com

Received: July 6, 2026
Revised: July 27, 2026
Accepted: September 20, 2026
Published online: October 15, 2026
Processing time: 100 Days and 0.2 Hours

Abstract

BACKGROUND

Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in patients with type 2 diabetes mellitus (T2DM), with insulin resistance as its core pathophysiological driver. The estimated glucose disposal rate (eGDR) is a simple surrogate for systemic insulin resistance, yet its association with MASLD in T2DM and the related gender heterogeneity remain unclear.

AIM

To investigate the association between the eGDR and MASLD in patients with T2DM, and to analyse the moderating effect of gender on this association.

METHODS

A cross-sectional study design was adopted, and 648 hospitalised patients with T2DM were consecutively enrolled. A multivariable logistic regression model was used to analyse the independent association between eGDR and MASLD; a restricted cubic spline (RCS) model was employed to analyse the dose-response relationship between the two; and the moderating effects of factors such as gender were assessed through stratified analysis and interaction tests.

RESULTS

The eGDR levels in patients with MASLD were significantly lower than those in patients without MASLD (P < 0.001). Multivariate logistic regression analysis showed that, with the lowest eGDR quartile (Q1) as the reference, patients in the highest quartile (Q4) had a 58% reduced risk of MASLD [odds ratio (OR) = 0.42, 95% confidence interval (CI): 0.25-0.70, P < 0.001], and a significant dose-dependent trend was observed. RCS analysis showed a linear inverse correlation between eGDR and the risk of MASLD in the overall population. Stratified analysis showed that among male patients, compared with the lowest quartile of eGDR, the risk of MASLD was reduced by 73% in the highest quartile (OR = 0.27, 95%CI: 0.14-0.51, P < 0.001), whereas no statistically significant difference was observed among female patients (OR = 0.71, 95%CI: 0.32-1.58, P = 0.401). Gender-stratified RCS analysis showed that eGDR was significantly and linearly negatively correlated with MASLD in the male cohort, whereas the association between the two was not statistically significant in the female cohort.

CONCLUSION

It has been demonstrated that eGDR is independently and negatively associated with the risk of MASLD in patients with T2DM, and that this association shows significant gender differences, being more pronounced in male patients.

Keywords: Type 2 diabetes mellitus; Estimated glucose disposal rate; Insulin resistance; Metabolic dysfunction-associated steatotic liver disease; Gender differences

Core Tip: This cross-sectional study demonstrates that estimated glucose disposal rate is independently and inversely associated with metabolic dysfunction-associated steatotic liver disease risk in type 2 diabetes mellitus patients in a linear dose-dependent pattern. The association presents significant gender heterogeneity, being more pronounced in males. Estimated glucose disposal rate may serve as a simple practical indicator for metabolic dysfunction-associated steatotic liver disease risk stratification in clinical practice.