Abstract: Objective To analyze the risk factors of type 2 diabetes mellitus (T2DM) combined with metabolically associated fatty liver disease (MAFLD), and explore the correlation with thyrotropin (TSH) and osteocalcin (OC). Methods A total of 372 T2DM patients admitted to the Department of Endocrinology of Haian People's Hospital from January 2022 to March 2024 were collected and divided into MAFLD group (n=228) and non-MAFLD group (n=144) according to the results of abdominal color ultrasonography. Baseline data and clinical indicators of the two groups were collected and compared. Multivariate logistic regression was used to analyze the risk factors for MAFLD in T2DM patients, and the evaluation value of individual risk factors and prediction model was plotted by ROC analysis. Results The levels of BMI, FBG, HbA1c, ALT, AST, ALP, TG, TyG and TSH in T2DM group with MAFLD were (26.38±1.45) kg/m², (8.35±1.76) mmol/L, 8.79%±1.83%, (35.68±5.92) U/L and (41.56±6.41) U /L, (79.68±9.53) U/L, (2.14±0.53) mmol/L, 8.85±1.79, (1.96±0.48) μU/mL, higher than that in the non-MAFLD group [(24.52±1.34) kg/m², (7.26±1.54) mmol/L, 7.32%±1.51%, (32.57±5.63) U/L, (37.18±6.15) U/L, (61.37±8.64) U/L, (1.85±0.49) mmol/L, 7.24±1.46, (1.63±0.42) μU/mL)]; The OC level in the MAFLD group was (4.02±0.85) ng/L, and the difference was statistically significant between two groups (6.38±1.02 ng/L) (t/χ²=6.028, 5.794,6.372,5.872, 5.659, 6.836, 5.328, 6.578, 7.204, 8.529, all P<0.05). Logistic regression analysis showed that increased levels of HbA1c, ALP, TyG and TSH and decreased levels of OC were independent influencing factors for the occurrence of MAFLD in T2DM patients (95%CI 0.964~1.478, 0.624~1.056, 1.027~1.619, 0.839~1.372, 0.706~1.235. OR=1.217, 0.839, 1.348, 1.105, 0.972, all P<0.05); TyG had the highest sensitivity and HbA1c had the highest specificity. Conclusion The elevated levels of HbA1c, ALP, TyG and TSH and the decreased levels of OC are independent risk factors for NAFLD in T2DM patients, which can provide a reference for early diagnosis and timely intervention.

Key words: Type 2 diabetes mellitus, Metabolically associated fatty liver disease, Risk factors, Thyrotropin, Osteocalcin