Abstract
Objective
To investigate the association between iron metabolism markers and microalbuminuria in patients with Type 2 diabetes mellitus (T2DM) and metabolic dysfunction‐associated steatotic liver disease (MASLD).
Methods
A total of 137 patients with T2DM and MASLD were enrolled and stratified into microalbuminuria‐positive and microalbuminuria‐negative groups based on the urinary albumin‐to‐creatinine ratio (UACR). Iron metabolism markers, including serum ferritin, serum iron, total iron‐binding capacity (TIBC), transferrin saturation (TS), and hepcidin, were measured. Hepatic iron and fat content were assessed using magnetic resonance imaging (MRI), including R2
∗
mapping (MRI‐R2
∗
) and proton density fat fraction (MRI‐PDFF).
Results
Patients with microalbuminuria had significantly higher levels of serum ferritin, serum iron, hepcidin, and MRI‐R2
∗
compared with those without microalbuminuria (all
p
r
s
= 0.208,
p
= 0.015) and MRI‐R2
∗
(
r
s
= 0.248,
p
= 0.003) were positively associated with UACR. However, after multivariable adjustment for confounding factors, MRI‐R2
∗
remained independently associated with microalbuminuria (
p
= 0.049).
Conclusions
Altered iron metabolism is associated with microalbuminuria in patients with T2DM and MASLD. MRI‐R2
∗
, a quantitative imaging marker of hepatic iron content, showed an independent association with microalbuminuria after multivariable adjustment and may provide complementary information for early renal injury assessment in this population.