ArticleCardiovascular diabetology2025
Combined impact of prediabetes and fatty liver index on cardiometabolic outcomes and mortality in middle aged adults: a nationwide cohort study.
Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of empagliflozin on liver fat reduction in type 2 diabetes and NAFLD: A systematic review and meta-analysis.Endocrine · 2026Pooled it
- Hepatic metabolic burden and all-cause mortality across glucose metabolism statuses in a cardiovascular-kidney-metabolic syndrome population: insights from the National Health and Nutrition Examination Survey (NHANES).Cardiovascular diabetology · 2026Article
- Plasma GLP-1 (Glucagon-like Peptide-1) Depletion Is Correlated with Dysregulation of Adipocytokine in Type 2 Diabetic Patients With or Without Metabolic-Associated Fatty Liver Disease (MAFLD): A Cross-Sectional Study Related to Gender-Sex Disparities.International journal of molecular sciences · 2026Article
- The fatty liver index exhibits a dual association with chronic obstructive pulmonary disease: a machine learning-based analysis of two independent cohorts.Frontiers in nutrition · 2026Article
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Authors and funding
13 authors.
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Abstract
backgroundTo investigate the combined effect of prediabetes and fatty liver index on incident diabetes (DM), major adverse cardiovascular events (MACE), and mortality in middle-aged adults.
methodsA nationwide cohort study was conducted involving 1,182,751 middle-aged adults aged 40 to 65 years, all of whom had no history of diabetes or cardiovascular disease. The primary outcomes of our study included incident DM, composite MACE and all-cause mortality.
resultsAmong the participants, 24.6% were diagnosed with prediabetes, while 8.8% had FLI ≥ 60 at baseline. Both conditions independently increased the risk of incident DM, composite MACE, and all-cause mortality. Stratification based on the presence of prediabetes and FLI ≥ 60 showed that their combination posed the highest risk for outcomes, even after adjusting for relevant covariates. For incident DM, the odds ratios (ORs) with 95% confidence intervals (CI) were as follows: 3.75 (3.69-3.81), 2.35 (2.29-2.42), and 6.80 (6.62-6.98) for prediabetes with FLI < 60, normoglycemia with FLI ≥ 60, and prediabetes with FLI ≥ 60, respectively. For composite MACE, the ORs (95% CI) were 1.02 (1.00-1.05), 1.23 (1.17-1.28), and 1.27 (1.21-1.33) for prediabetes with FLI < 60, normoglycemia with FLI ≥ 60, and prediabetes with FLI ≥ 60, respectively. For all-cause mortality, ORs (95% CI) were 1.12 (1.08-1.15), 1.51 (1.43-1.59), and 1.69 (1.60-1.79) for prediabetes with FLI < 60, normoglycemia with FLI ≥ 60, and prediabetes with FLI ≥ 60, respectively.
conclusionThe coexistence of prediabetes and FLI ≥ 60, which is a surrogate marker of hepatic steatosis, demonstrated a combined effect, additively increasing the risk of incident DM, composite MACE, and all-cause mortality in middle-aged adults.
trial registrationNot applicable (retrospectively registered).
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