Dietary impact on the risk of progression to hepatic fibrosis in patients with type 2 diabetes

Yesmine Elloumi; Mouna Elleuch; Nada Hassairi; Maryem Akacha; kouloud boujelben; Hadjkacem Faten; Nadia Charfi; Mouna Mnif; Salah Dhoha Ben; Majdoub Nabila Rekik

doi:10.1530/endoabs.110.EP529

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Endocrine Abstracts (2025) 110 EP529 | DOI: 10.1530/endoabs.110.EP529

ECEESPE2025 ePoster Presentations Diabetes and Insulin (245 abstracts)

Dietary impact on the risk of progression to hepatic fibrosis in patients with type 2 diabetes

Yesmine Elloumi ¹ , Mouna Elleuch ¹ , Nada Hassairi ¹ , Maryem Akacha ¹ , kouloud boujelben ¹ , Hadjkacem Faten ¹ , Nadia Charfi ¹ , Mouna Mnif ¹ , Dhoha Ben Salah ¹ & Nabila Rekik Majdoub ¹

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¹Hedi Chaker University Hospital, Endocrinology Department, Sfax, Tunisia

JOINT471

Background: Metabolic Associated Steatotic Liver Disease (MASLD) is an emerging condition among individuals with Type 2 Diabetes Mellitus (T2DM). Diet plays a critical role in metabolic health, yet its precise effect on the risk of progression to fibrosis in MASLD remains underexplored understanding the dietary factors contributing to its progression toward fibrosis is becoming crucial. This study aims to evaluate the dietary impac on the risk of progression from MASLD to fibrosis in case of T2DM.

Methods: This analytical study included type 2 diabetic patients with confirmed MASLD, followed at the Endocrinology-Diabetology Department in Sfax university in Tunisia. The fibrosis-4 index (FIB-4) and the NAFLD fibrosis score (NFS) were used to evaluate the risk of advanced fibrosis among the patients. For each patient, we assessed macronutrient intake, including daily caloric intake in Kcal, as well as the percentage of daily intake from lipids, proteins, and carbohydrates. We also evaluated the intake of saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids along with micronutrient intake, including fiber (g/day), iron (mg/day), calcium (mg/day), and cholesterol (mg/day).

Results: Our study was conducted on 202 T2DM patients with confirmed MASLD. Total energy intake was not associated with the progression MASLD to fibrosis, as assessed by the FIB-4 and NFS scores (P = 0.223 and P = 0.163, respectively). Similarly, macronutrient intake did not correlate with fibrosis progression based on the NFS score. However, when the FIB-4 score was applied, significant associations were observed, specifically in carbohydrate intake (P = 0.003), lipid intake (P = 0.041), and polyunsaturated fatty acids intake (P = 0.008). No significant differences were found in protein intake or consumption of saturated and monounsaturated fatty acids, regardless of the score used. Additionally, we found that individuals with advanced fibrotic risk for MASLD, according to the NFS score, had higher dietary iron intake (P = 0.048). In contrast, no significant differences were observed in the intake of calcium, fiber, or cholesterol.

Conclusion: Our study aims to provide insights into the role of diet in the progression of MASLD to fibrosis in T2DM patients, offering potential avenues for targeted nutritional strategies to prevent or slow this progression.