Abstract
OBJECTIVE: To explore the relationship between controlled attenuation parameters (CAP) of the liver and the risk of type 2 diabetes mellitus (T2DM), and to determine the optimal cutoff value of CAP for predicting T2DM. METHODS: This study employed a cross-sectional study design, enrolling 7035 participants. CAP values were measured using hepatic transient elastography, and participants were categorized into low (≤231 dB/m), middle (232~269 dB/m), and high (≥270 dB/m) groups. Multivariate logistic regression analysis was used to assess the association between CAP and T2DM, and the optimal cutoff value was determined using receiver operating characteristic (ROC) curves. RESULTS: After adjusting for potential confounders, participants in the high-CAP group had a significantly greater risk of developing T2DM than did those in the low-CAP group (OR=1.545; 95% CI=1.263-1.890; p<0.001). Stratified analyses revealed that compared with a low CAP, a 1.0-increased CAP was associated with a 0.852-fold increased T2DM risk in people aged <55 years (OR=1.852; 95% CI=1.405-2.441; p<0.001) and a 0.6-fold increased T2DM risk in overweight patients (BMI≥24 kg/m2) (OR=1.600; 95% CI=1.127-2.271; p=0.009). ROC analysis revealed an optimal CAP cutoff value of 246.5 dB/m for T2DM prediction, with an area under the curve of 0.569 (specificity=48.2%, sensitivity=64.2%). CONCLUSION: CAP levels are associated with a dose-response relationship with the risk of T2DM, particularly in younger and overweight populations. Although CAP has limited predictive value on its own, it can be used as an auxiliary indicator for T2DM risk screening.