Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a multisystem disorder associated with cardiometabolic complications. Emerging evidence suggests a potential link between hepatic steatosis and diabetic kidney disease, particularly microalbuminuria. This study aimed to evaluate the association between hepatic steatosis burden and urinary albumin-creatinine ratio (UACR) in patients with type 2 diabetes mellitus.

Methods: In this cross-sectional study, 95 patients with type 2 diabetes mellitus were evaluated. Hepatic steatosis was assessed using computed tomography-derived liver attenuation index (LAI) and steatosis grading. UACR was used as a marker of microalbuminuria. Correlation analysis and multivariate linear regression were performed to determine the relationship between hepatic steatosis parameters and albuminuria.

Results: The mean age of participants was 53.16 ± 9.94 years, with a mean BMI of 24.97 ± 2.03 kg/m². UACR increased progressively with higher grades of hepatic steatosis (Kruskal-Wallis H = 49.53, p < 0.001). LAI showed a significant negative correlation with UACR (r = −0.66, p < 0.001). In multivariate regression analysis, LAI (β = −1.69, p < 0.001) and BMI (β = 2.13, p = 0.004) were independently associated with UACR.

Conclusion: Hepatic steatosis burden is significantly associated with microalbuminuria in patients with type 2 diabetes mellitus, suggesting its potential role as an early marker of renal endothelial dysfunction.

Jog is a consultant endocrinologist and academician from India, currently serving in the Department of Endocrinology at Sri Devraj Urs Medical College, Kolar. She is actively involved in clinical endocrinology, diabetes care, medical education, and the development of advanced endocrine training programs and teaching of post-graduates. Jog has a special interest in diabetes, metabolic medicine, Gestational Diabetes, and Obesity. 

Jog has presented scientific work at national conferences and has contributed to peer-reviewed publications in the field of endocrinology and metabolism. Jog is committed to advancing endocrine care through clinical excellence, research, education, and public awareness initiatives, with a particular focus on improving outcomes for people living with diabetes and endocrine disorders.