CORRELATION BETWEEN BODY MASS INDEX AND DEGREE OF HEPATIC STEATOSIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
DOI:
https://doi.org/10.71282/jurmie.v3i11.2698Keywords:
Type 2 Diabetes Mellitus, Body Mass Index, Hepatic SteatosisAbstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition characterized by elevated blood glucose levels resulting from insulin resistance, and it is frequently accompanied by hepatic steatosis, now known as metabolic dysfunction-associated steatotic liver disease (MASLD). An elevated body mass index (BMI) indicates visceral fat accumulation, which in turn triggers the release of free fatty acids and proinflammatory cytokines and may thereby damage hepatocytes. This study aimed to examine the relationship between BMI and the severity of hepatic steatosis in patients with T2DM at Sultan Agung Islamic Hospital, Semarang. This study used an analytic observational approach with a cross-sectional design. A total of 70 patients with T2DM who met the inclusion criteria were selected by consecutive sampling from medical records for the period 2022–2026. BMI was categorized according to WHO criteria, while the degree of hepatic steatosis was assessed by ultrasonography on a three-level scale: mild, moderate, and severe. Data analysis included the Kolmogorov–Smirnov normality test and Spearman rank correlation. The mean BMI of the subjects was 28.19 ± 5.88 kg/m², and the largest proportion fell into the obesity grade I category (42.9%). The most common degree of hepatic steatosis was mild (55.7%), followed by moderate (31.4%) and severe (12.9%). The data did not meet the assumption of normality (p = 0.000), so Spearman correlation was used. It showed a significant positive correlation between BMI and the degree of hepatic steatosis (r = 0.194; p = 0.008). In conclusion, there is a significant but weak positive correlation between BMI and the degree of hepatic steatosis in patients with type 2 diabetes mellitus at Sultan Agung Islamic Hospital, Semarang.
Downloads
References
Andriawan, K., Putri, R.A., Sari, D.P. and Wijaya, A. (2025) 'Hubungan indeks massa tubuh pada pasien diabetes melitus tipe 2 dengan komplikasi retinopati diabetik di Rumah Sakit Bintang Amin', Jurnal Ilmu Kedokteran dan Kesehatan, 12(9), pp. 1961–1970.
Chamarthi, V.S., Garg, C. and Daley, S.F. (2025) 'Obesity and type 2 diabetes', in StatPearls. Treasure Island (FL): StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK592412/ (Accessed: 28 October 2026).
Chandrasekaran, P. and Bhatt, D.L. (2024) 'The role of obesity in type 2 diabetes mellitus: an overview', Metabolites, 14(2), p. 97. doi: 10.3390/metabo14020097.
Davies, M.J., Aroda, V.R., Collins, B.S., Gabbay, R.A., Green, J., Maruthur, N.M., et al. (2022) 'Management of hyperglycemia in type 2 diabetes, 2022: a consensus report by the American Diabetes Association and the European Association for the Study of Diabetes', Diabetes Care, 45(11), pp. 2753–2786. doi: 10.2337/dci22-0034.
DeFronzo, R.A., Ferrannini, E., Groop, L., Henry, R.R., Herman, W.H., Holst, J.J., et al. (2021) 'Type 2 diabetes mellitus', Nature Reviews Disease Primers, 7(1), p. 46. doi: 10.1038/s41572-021-00265-0.
Goyal, R., Singhal, M. and Jialal, I. (2023) 'Type 2 diabetes', in StatPearls. Treasure Island (FL): StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK513253/ (Accessed: 28 October 2026).
Kawai, T., Autieri, M.V. and Bhatt, D.L. (2021) 'Adipose tissue inflammation and metabolic dysfunction in obesity', American Journal of Physiology-Cell Physiology, 320(3), pp. C375–C391. doi: 10.1152/ajpcell.00379.2020.
Kementerian Kesehatan Republik Indonesia (2026) Pedoman Nasional Pelayanan Klinis: Tata Laksana Diabetes Tipe 2 Dewasa. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/302/2026. Jakarta: Kementerian Kesehatan Republik Indonesia.
Li, J., Zou, B., Yeo, Y.H., Feng, Y., Xie, X., Lee, D.H., et al. (2021) 'Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis', Lancet Gastroenterology & Hepatology, 4(6), pp. 389–398. doi: 10.1016/S2468-1253(19)30039-1.
Lin, H., Wang, Z. and Tang, J. (2026) 'Metabolic characteristics and risk profile of non-obese fatty liver disease in an elderly Chinese community cohort', BMC Gastroenterology, 26(1), p. 244. doi: 10.1186/s12876-026-04730-8.
Liu, W., Xu, L., Yu, Y., Qiao, L., Zhang, L., Chu, X., Jing, H. and Cao, L. (2025) 'Correlation between lipid accumulation product and metabolic dysfunction-associated steatotic liver disease in Chinese adults with type 2 diabetes mellitus', Diabetes, Metabolic Syndrome and Obesity, 18, pp. 2007–2017. doi: 10.2147/DMSO.S518649.
Lu, X., Xie, Q., Pan, X., Zhang, R., Zhang, X., Peng, G., Zhang, Y., Shen, S. and Tong, N. (2024) 'Type 2 diabetes mellitus in adults: pathogenesis, prevention and therapy', Signal Transduction and Targeted Therapy, 9(1), p. 262. doi: 10.1038/s41392-024-01951-9.
Magliano, D.J. and Boyko, E.J. (eds.) (2025) IDF Diabetes Atlas. 11th edn. Brussels: International Diabetes Federation. Available at: https://diabetesatlas.org/atlas/eleventh-edition/.
Muharram, F.R., Sari, D.K., Wulandari, R.A., Prasetyo, B. and Nugroho, A. (2025) 'Trends of diabetes and pre-diabetes in Indonesia 2013–2023: a serial analysis of national health surveys', BMJ Open, 15(3), p. e089712. doi: 10.1136/bmjopen-2024-089712.
Petzold, G. (2022) 'Role of ultrasound methods for the assessment of NAFLD', Journal of Clinical Medicine, 11(15), p. 4581. doi: 10.3390/jcm11154581.
Rinella, M.E., Lazarus, J.V., Ratziu, V., Francque, S.M., Sanyal, A.J., Kanwal, F., et al. (2023) 'A multisociety Delphi consensus statement on new fatty liver disease nomenclature', Hepatology, 78(6), p. 1966. doi: 10.1097/HEP.0000000000000520.
Salleh, M.M.M., Baharudin, N., Ismail, N.H. and Ahmad, W.A.N.W. (2025) 'Association between body mass index and diabetes mellitus control among patients attending a primary care clinic', Malaysian Family Physician, 20, p. e2025006. doi: 10.51866/oa.651.
Shaniaputri, T., Iskandar, E. and Fajriansyah, A. (2022) 'Prevalensi retinopati diabetik di puskesmas di Bandung Raya periode Januari 2019–Desember 2020', eJurnal Kedokteran Indonesia, 10(1), pp. 39–46. doi: 10.23886/ejki.10.119.39.
Soelistijo, S.A. (ed.) (2021) Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia 2021. Jakarta: PB PERKENI.
Soelistijo, S.A. (ed.) (2024) Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia 2024. Jakarta: PB PERKENI.
Solis-Herrera, C., Triplitt, C. and DeFronzo, R.A. (2025) Pathogenesis of type 2 diabetes mellitus. South Dartmouth (MA): Endotext/MDText.com. Available at: https://www.ncbi.nlm.nih.gov/books/NBK279115/.
Sun, Z., Yang, L. and Wang, N. (2026) 'Body mass index outperforms triglyceride-glucose index in predicting MAFLD in type 2 diabetes: a cross-sectional mediation and interaction analysis', Diabetes, Metabolic Syndrome and Obesity, 19, pp. 1–11. doi: 10.2147/DMSO.S612508.
Wang, J., Yan, S., Cui, Y., Chen, F., Piao, M., Cui, W., et al. (2022) 'The diagnostic and prognostic value of the triglyceride-glucose index in metabolic dysfunction-associated fatty liver disease (MAFLD): a systematic review and meta-analysis', Nutrients, 14(23), p. 4969. doi: 10.3390/nu14234969.
Yan, K., Li, S., Wang, X., Chen, L. and Zhao, J. (2024) 'Recent advances in the effect of adipose tissue inflammation on insulin resistance', Biochimica et Biophysica Acta – Molecular and Cell Biology of Lipids, 1869(7), p. 159529. doi: 10.1016/j.bbalip.2024.159529.
Ye, Q., Zou, B., Yeo, Y.H., Li, J., Huang, D.Q., Wu, Y., et al. (2021) 'Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis', Lancet Gastroenterology & Hepatology, 5(8), pp. 739–752. doi: 10.1016/S2468-1253(20)30077-7.
Younossi, Z.M., Golabi, P., Paik, J.M., Henry, A., Van Dongen, C. and Henry, L. (2023) 'The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review', Hepatology, 77(4), pp. 1335–1347.
Zhang, S., Du, T., Zhang, J., Lu, H., Lin, X., Xie, J., et al. (2022) 'The triglyceride and glucose index (TyG) is an effective biomarker to identify nonalcoholic fatty liver disease', Lipids in Health and Disease, 16(1), p. 15. doi: 10.1186/s12944-017-0409-6.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Anisa Khusnatunnadliroh, Mohamad Arif (Author)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
