{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T07:04:09Z","timestamp":1789974249704,"version":"4.0.1"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metabolic dysfunction\u2010associated steatotic liver disease (MASLD), previously termed non\u2010alcoholic fatty liver disease, affects an estimated 30%\u201370% of people with type 2 diabetes (T2D), with prevalence likely to be higher in quaternary diabetes clinics. Documentation using the International Classification of Diseases, Tenth Revision, Australian Modification (ICD\u201010\u2010AM) may substantially underestimate disease burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the prevalence of MASLD identified by ICD\u201010\u2010AM coding with imaging\u2010based diagnosis using transient elastography (FibroScan\u00ae) and determine disease severity and clinical characteristics associated with significant fibrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults attending a quaternary diabetes clinic underwent retrospective review of electronic health records (August 2020\u2013December 2023) for ICD\u201010\u2010AM\u2010coded MASLD, excluding other chronic liver diseases. A prospective cohort of consecutive clinic attendees underwent FibroScan\u00ae assessment for imaging\u2010based diagnosis of MASLD and fibrosis staging. Clinical characteristics associated with significant fibrosis were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ICD\u201010\u2010AM coding identified MASLD in 3% (85\/2589) of patients, compared with 83% (81\/103) diagnosed by FibroScan\u00ae. Significant fibrosis was present in 45% (46\/103). Patients with significant fibrosis had higher body mass index (34 vs 28 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.01), alanine aminotransferase (40 vs 26 U\/L,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.001), gamma\u2010glutamyl transferase (54 vs 30 U\/L,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.001), lower high\u2010density lipoprotein cholesterol (1.03 vs 1.15\u2009mmol\/L,\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.04), younger age (62 vs 67\u2009years,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.05) and shorter diabetes duration (11 vs 18\u2009years,\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this quaternary diabetes clinic, ICD\u201010\u2010AM coding substantially under\u2010recognised MASLD compared with FibroScan\u00ae, which identified a high prevalence of MASLD and significant fibrosis. These findings highlight important gaps in diagnostic coding and clinical awareness of MASLD in T2D.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70587","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:42:41Z","timestamp":1789972961000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Discordance between\n                    <scp>ICD<\/scp>\n                    \u201010\u2010\n                    <scp>AM<\/scp>\n                    coding and confirmed prevalence of\n                    <scp>MASLD<\/scp>\n                    in a quaternary diabetes service"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6607-1387","authenticated-orcid":false,"given":"Janakan","family":"Selvarajah","sequence":"first","affiliation":[{"name":"Department of Gastroenterology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddison","family":"Terlato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weilun","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Salehi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faris","family":"Gondal","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3579-1715","authenticated-orcid":false,"given":"Karen","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spiros","family":"Fourlanos","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The Royal Melbourne Hospital  Melbourne Victoria 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