Comparison of sleep disorders in diabetic and non-diabetic subjects with Metabolic dysfunction–associated steatotic liver disease (MASLD)
Abstract
Abstract Introduction : Metabolic dysfunction–associated steatotic liver disease (MASLD) is associated with type 2 diabetes mellitus (T2DM) and sleep disorders, particularly obstructive sleep apnea (OSA). However, the influence of diabetes on sleep disorders in MASLD patients remains unclear. Purpose : To compare sleep disorders in diabetic and non-diabetic individuals with MASLD. Methods : This cross sectional study was conducted among diabetic and non-diabetic adults undergoing transient elastography (FibroScan®) at Imam Khomeini Hospital in Ahvaz, Iran in 2025. Steatosis severity was assessed by controlled attenuation parameter (CAP). Sleep disorders were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), STOP-BANG questionnaire, and Insomnia Severity Index (ISI). Results : A total of 230 participants were enrolled, including 102 diabetics and 128 non-diabetic individuals. Mean sleep questionnaire scores did not differ significantly between groups (all P > 0.05). However, OSA prevalence was higher in diabetic than non-diabetic participants (72.5% vs. 57.0%, P = 0.027). MASLD participants had higher prevalence of excessive daytime somnolence (EDS) (29.41% vs. 15.63%, P = 0.027) and insomnia (60.78% vs. 46.09%, P = 0.029) than non-MASLD participants. No significant correlations between CAP and sleep questionnaire scores were observed in MASLD, non-MASLD, or diabetic participants (all P > 0.05). In contrast, among non-diabetic…
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