ArticleBMJ (Clinical research ed.)2024
Association of non-alcoholic fatty liver disease with cardiovascular disease and all cause death in patients with type 2 diabetes mellitus: nationwide population based study.
Article in BMJ (Clinical research ed.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 2 of them syntheses that pooled it.
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Who cites it
98 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Global epidemiology of diabetes and prediabetes in lean or non-obese patients with NAFLD: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Pharmacological effects of dihydromyricetin in preclinical models of NAFLD: a systematic review and meta-analysis stratified by dose and duration.Frontiers in pharmacology · 2026Pooled it
- Trial
- Is MASLD an independent risk factor for micro- and macrovascular complications of diabetes? A critical reappraisal and future directions.Diabetologia · 2026Review
- Clinical obesity in Asian people: bridging the gap between adiposity and disease.Nature reviews. Endocrinology · 2026Review
- Cardiovascular disease risk in patients with and without metabolic dysfunction-associated steatotic liver disease: A clinical and subclinical evaluation.American heart journal plus : cardiology research and practice · 2026Review
- Revisiting Insulin Resistance in the Pathophysiology of Type 2 Diabetes Mellitus: A Multi-Organ Perspective.Diabetes & metabolism journal · 2026Review
- Predictive significance of triglyceride-glucose index in forecasting adverse cardiovascular events among Type 2 diabetes mellitus patients with co-existing metabolic dysfunction-associated steatotic liver disease (MASLD): evidence from two cohort studies.Cardiovascular diabetology · 2026Article
- Discordant high remnant cholesterol with LDL-C increases the metabolic dysfunction-associated steatotic liver disease risk in patients with type 2 diabetes mellitus.BMJ open diabetes research & care · 2026Article
- Association between serum methylmalonic acid and metabolic dysfunction-associated steatotic liver disease: NHANES-based study.Medicine · 2026Article
- Adding Semaglutide to SGLT2 Inhibitors Reduces Liver Enzymes in Patients with Type 2 Diabetes Complicated by Metabolic Dysfunction Associated Steatotic Liver Disease: A Retrospective Observational Study.Internal medicine (Tokyo, Japan) · 2026Observational
- Association of Metabolic Dysfunction-Associated Steatotic Liver Disease and Kidney Failure in the CKD Population.Kidney international reports · 2026Article
- Metabolism-related genes CYP4F2, CYP8B1, and SP1 link type 2 diabetes mellitus and non-alcoholic fatty liver disease: A multi-omics and clinical validation study.Functional & integrative genomics · 2026Article
- Precision Exercise in Type 2 Diabetes Mellitus: Targeting Signaling Networks for Lipid Homeostasis.Metabolites · 2026Review
- Outcomes of oral antidiabetic drugs in metabolic dysfunction-associated steatotic liver disease: a nationwide target trial emulation study.Clinical and molecular hepatology · 2026Article
- Pediococcus acidilactici PA-1 Alleviates Diet-Induced Obesity by Modulating Hepatic Amino Acid Metabolism and Gut Microbiota in Mice.Probiotics and antimicrobial proteins · 2026Article
- Disulfidptosis induced by intermittent fasting and metformin enhances the efficacy of anti-PD-1 therapy in renal cancer.Cell communication and signaling : CCS · 2026Article
- Using an integrative multi-omics and in vitro approach to investigate the role of tris(2-butoxyethyl) phosphate in promoting hepatic steatosis.BMJ open gastroenterology · 2026Article
- Real-world evidence in metabolic dysfunction-associated steatotic liver disease (MASLD): insights, challenges, and future directions.The Lancet regional health. Europe · 2026Review
- Risk of Microvascular and Macrovascular Complications in Patients with Type 2 Diabetes and Metabolic Dysfunction-Associated Steatohepatitis: A Retrospective Cohort Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Article
38 more citing papers are in PubMed but not listed here.
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the risk of non-alcoholic fatty liver disease (NAFLD) for cardiovascular disease and all cause death in patients with type 2 diabetes mellitus (T2DM).
designNationwide population based study.
settingLongitudinal cohort study in Korea.
participants7 796 763 participants in the National Health Screening Programme in 2009 were divided into three groups based on NAFLD status: no NAFLD (fatty liver index<30); grade 1 NAFLD (30≤fatty liver index<60); and grade 2 NAFLD (fatty liver index≥60). Median follow-up was 8.13 years.
main outcome measuresThe primary outcome was incident cardiovascular disease (myocardial infarction, ischaemic stroke) or all cause death.
resultsOf 7 796 763 participants, 6.49% (n=505 763) had T2DM. More patients with T2DM had grade 1 NAFLD (34.06%) and grade 2 NAFLD (26.73%) than those without T2DM (grade 1 NAFLD: 21.20%; grade 2 NAFLD: 10.02%). The incidence rate (per 1000 person years) of cardiovascular disease and all cause death increased in the order of no NAFLD, grade 1 NAFLD, and grade 2 NAFLD, and the incidence rates in patients with T2DM were higher than those in patients without T2DM. The five year absolute risk for cardiovascular disease and all cause death increased in the order of no NAFLD, grade 1 NAFLD, and grade 2 NAFLD in patients without and with T2DM (no NAFLD, without T2DM: 1.03, 95% confidence interval 1.02 to 1.04, and 1.25, 1.24 to 1.26, respectively; grade 1 NAFLD, without T2DM: 1.23, 1.22 to 1.25, and 1.50, 1.48 to 1.51, respectively; grade 2 NAFLD, without T2DM: 1.42, 1.40 to 1.45, and 2.09, 2.06 to 2.12, respectively; no NAFLD, with T2DM: 3.34, 3.27 to 3.41, and 3.68, 3.61 to 3.74, respectively; grade 1 NAFLD, with T2DM: 3.94, 3.87 to 4.02, and 4.25, 4.18 to 4.33, respectively; grade 2 NAFLD, with T2DM: 4.66, 4.54 to 4.78, and 5.91, 5.78 to 6.05, respectively). Patients with T2DM and without NAFLD had a higher five year absolute risk for cardiovascular disease and all cause death than those without T2DM and with grade 2 NAFLD. Risk differences for cardiovascular disease and all cause death between no NAFLD and grade 1 or grade 2 NAFLD were higher in patients with T2DM than in those without T2DM.
conclusionsNAFLD in patients with T2DM seems to be associated with a higher risk of cardiovascular disease and all cause death, even in patients with mild NAFLD. Risk differences for cardiovascular disease and all cause death between the no NAFLD group and the grade 1 or grade 2 NAFLD groups were higher in patients with T2DM than in those without T2DM.
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