The Role Of Indian Diabetic Risk Score In Predicting Metabolic Dysfunction Associated Steatotic Liver Diease In Non-Diabetic Population

Abstract

Background: Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) represents a continuum of hepatic involvement ranging from uncomplicated fat accumulation to inflammatory injury, progressive fibrosis, cirrhosis, and ultimately hepatocellular carcinoma. In many non-diabetic individuals, MASLD remains clinically silent and is often driven by metabolic derangements such as abdominal adiposity, insulin resistance, and lipid abnormalities. Identifying individuals at risk at an early stage is essential to halt disease progression and reduce long-term hepatic and cardiovascular morbidity. The Indian Diabetes Risk Score (IDRS), a simple and validated screening instrument for diabetes, may also reflect underlying metabolic risk and thereby serve as a potential indicator for MASLD.

Aim: To assess the utility of the Indian Diabetes Risk Score as a predictor of MASLD in adults without diabetes.

Materials and Methods: A hospital-based cross-sectional study was carried out over an 18-month period at Aarupadai Veedu Medical College and Hospital, enrolling 93 non-diabetic adults aged 18–65 years. All participants were evaluated using the IDRS, along with detailed anthropometric measurements and biochemical investigations including fasting blood sugar, HbA1c, lipid profile, and liver function tests. Abdominal ultrasonography was performed to detect and grade hepatic steatosis. Statistical analysis involved chi-square testing and Pearson’s correlation, with statistical significance defined as p<0.05.

Results: The mean age of the study cohort was 42.76 ± 14.46 years, with females comprising 62.4% of participants. Higher IDRS categories showed a significant association with ultrasonographic evidence of fatty liver (χ² = 30.16, p = 0.01), with most high-risk individuals demonstrating grade 1 or grade 2 steatosis. IDRS scores exhibited significant positive correlations with age (r = 0.587), fasting blood sugar (r = 0.440), HbA1c (r = 0.573), body mass index (r = 0.545), and waist circumference (r = 0.451). In addition, ultrasonographic abnormalities were significantly linked to advancing age and elevated fasting glucose levels.

Conclusion: The Indian Diabetes Risk Score emerges as a practical, non-invasive, and cost-effective tool for identifying non-diabetic individuals at increased risk of MASLD. Its use in routine clinical settings may facilitate early recognition and prompt lifestyle-based interventions, thereby helping to prevent progression to advanced liver disease and related metabolic complications.