Abstract
This study aimed to investigate the relationship between the plasma lipidome and metabolic dysfunction-associated steatotic liver disease (MASLD) in type 2 diabetes. Initially, we conducted a plasma lipidome analysis using supercritical fluid chromatography-tandem mass spectrometry in 143 patients with type 2 diabetes with and without MASLD. Of the 349 lipid species identified, 13 had higher levels and a fold-change ≥2 in the MASLD group than in the non-MASLD group; 10 of these 13 lipids were triglycerides (TGs). The constituent fatty acid (FA) in TGs that exhibited the greatest difference between patients with and without MASLD was myristic acid (FA 14:0). The presence of MASLD was an independent explanatory factor for high FA 14:0 levels in TGs, even after adjusting for covariates. Next, we assessed whether the levels of lipids identified in the initial analysis were influenced by comprehensive diabetes treatment in 26 patients. After comprehensive diabetes treatment of 2 weeks, FA levels in many TGs significantly decreased; especially FA 14:0 levels, and this reduction was more pronounced in patients with MASLD. These results suggest that various plasma lipids, particularly TGs comprising FA 14:0, may be associated with the pathogenesis of MASLD in patients with type 2 diabetes. ARTICLE HIGHLIGHTS: Changes in blood lipid profiles in type 2 diabetes, particularly when complicated by metabolic dysfunction-associated steatotic liver disease (MASLD), have not been fully elucidated. Does MASLD influence the plasma lipidome in patients with type 2 diabetes? Patients with MASLD exhibited elevated levels of myristic acid (FA 14:0) in plasma triglycerides, which significantly decreased after comprehensive diabetes treatment. Elevated FA 14:0 levels in triglycerides may be associated with MASLD pathogenesis in type 2 diabetes.