ArticleFrontiers in medicine2026
Metabolic dysfunction-associated fatty liver disease increases the risk of new-onset type 2 diabetes mellitus: a retrospective cohort study based on health check-up data.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most prevalent chronic liver condition globally, yet its prospective association with incident type 2 diabetes mellitus (T2DM) in the general health check-up population requires further elucidation. This study aimed to investigate whether baseline MAFLD increases the risk of new-onset T2DM in a health check-up cohort. Materials and methods: This retrospective cohort study initially screened 1,520 individuals from the health check-up database; after applying strict exclusion criteria (including baseline T2DM, other liver diseases, malignancy, missing key data, and loss to follow-up), 186 participants without baseline T2DM were finally included. These participants underwent annual health examinations at Shanxi Bethune Hospital Health Check-up Center from 2020 to 2024. Baseline anthropometric measurements, biochemical parameters, and medical histories were collected. The primary outcome was new-onset T2DM over 5 years. Associations were analyzed using Kaplan-Meier methods and multivariable Cox regression. The primary analysis was adjusted for age, sex, and body mass index (BMI); a fully adjusted model including additional metabolic covariates was performed as a sensitivity analysis. Results: Over a median 60-month follow-up, 22 new T2DM cases occurred. The 5-year cumulative incidence of T2DM was significantly higher in the MAFLD group than in the non-MAFLD group (18.9% vs. 5.6%, Conclusion: Baseline MAFLD may be associated with an increased risk of new-onset T2DM within 5 years in a health check-up population, although these preliminary findings require confirmation in larger studies. Both lean and overweight/obese MAFLD subtypes showed associations with an elevated risk of T2DM in exploratory analyses, although the finding for lean MAFLD (based on only 15 individuals and 3 T2DM events) should be considered hypothesis-generating and preliminary and requires validation in larger cohorts. Early screening and lifestyle interventions for individuals with MAFLD are of paramount clinical importance for diabetes prevention.
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