{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T08:09:17Z","timestamp":1785658157640,"version":"3.56.0"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This cross-sectional study aimed to elucidate the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and diabetic cardiovascular autonomic neuropathy (DCAN) in patients with type 2 diabetes mellitus (T2DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study involved patients with T2DM. DCAN was diagnosed using standardized cardiovascular autonomic reflex tests (CARTs) with a total score\u22652. MAFLD was defined by the presence of fatty liver disease and T2DM, excluding other liver diseases. The fibrosis-4 (FIB-4) &amp;gt;1.3 indicated a potential risk of fibrosis based on prior studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 30.52% (76\/249) patients had DCAN. Patients with MAFLD had a significantly higher prevalence of DCAN than those without (36.49% vs. 21.78%,\n                      <jats:italic>P=0.013<\/jats:italic>\n                      ). Univariable analysis revealed a significant association between MAFLD and DCAN (OR = 2.06, 95% CI: 1.16-3.68,\n                      <jats:italic>P=0.014<\/jats:italic>\n                      ). This association remained significant even after multivariable adjustment for demographics, diabetes duration, comorbidities (hypertension, diabetic peripheral neuropathy, diabetic retinopathy, metabolic syndrome), and renal function (adjusted OR = 2.76, 95% CI: 1.44-5.29,\n                      <jats:italic>P=0.002<\/jats:italic>\n                      ). Among T2DM patients with MAFLD, a high FIB-4 index (&amp;gt;1.3) was independently associated with a substantially increased DCAN risk (adjusted OR = 2.81, 95% CI: 1.19-6.63,\n                      <jats:italic>P=0.018<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MAFLD is independently associated with a higher prevalence of DCAN in patients with T2DM. The risk was further amplified when high FIB-4 index (FIB-4 &amp;gt;1.3) was present among those with MAFLD. Hence, screening for MAFLD and its associated high FIB-4 levels may help identify patients with T2DM at a higher risk of DCAN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1711660","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:22:23Z","timestamp":1769577743000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between metabolic dysfunction-associated fatty liver disease and cardiovascular autonomic neuropathy in type 2 diabetes"],"prefix":"10.3389","volume":"16","author":[{"given":"Rong","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Guangdong Provincial People\u2019s Hospital(Guangdong Academy of Medical Sciences), Southern Medical University","place":["Guangzhou, Guangdong, 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