Zhejiang University index - connecting type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: Clinical utility and future horizons

Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the main comorbidity of type 2 diabetes mellitus, yet often under-recognized in daily clinical practice. Although liver biopsy is still considered to be the standard method for MASLD diagnosis, it is too invasive to be widely adopted in mass screenings. Recently, the Zhejiang University index using simple anthropometric and biochemical parameters was assessed in type 2 diabetes mellitus patients and found strongly associated with both the presence and severity of MASLD. These new findings illustrate that some metabolic composite scores may help complement current diagnostic strategies. In this editorial, we contextualize them, review existing ones and contrast these results, and finally explore possible research areas or directions in clinical applications.