ArticleCardiovascular diabetology2025
The role of insulin resistance in the longitudinal progression from NAFLD to cardiovascular-kidney-metabolic disease.
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 7 papers.
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Who cites it
7 citing papers in PubMed.
- Nonalcoholic Fatty Liver Disease as a Risk Marker for Incident Type 2 Diabetes Mellitus: A Systematic Review.Cureus · 2026Review
- Triglyceride-Glucose Index and Acute Kidney Injury: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Changes in estimated glucose disposal rate and future stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0-3.Scientific reports · 2026Article
- A Cross-Ethnicity Validated Machine Learning Model for the Progression of Chronic Kidney Disease in Individuals over 50 Years Old.Journal of clinical medicine · 2026Article
- Associations between novel triglyceride glucose and adiposity-related indices and risk of metabolic dysfunction-associated steatotic liver disease: the mediating role of biological aging and evidence from the UK Biobank.Frontiers in endocrinology · 2026Article
- GLUT5-Driven Gut-Liver Axis Injury Mediating Olanzapine-Induced NAFLD and Dapagliflozin Intervention.Drug design, development and therapy · 2026Article
- Dynamic interplay of atherogenic index and body roundness in cardio-renal-metabolic disease: a multi-state analysis.BMC public health · 2025Article
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
objectiveThis study aimed to elucidate the role of insulin resistance in the progression from non-alcoholic fatty liver disease (NAFLD) to cardiovascular-kidney-metabolic (CKM) diseases, and to explore the potential influence of lifestyle factors.
methodsThis study included participants free of NAFLD and CKM diseases from the UK Biobank. Insulin resistance was assessed using the TyG index. CKM diseases include ischemic stroke (IS), ischemic heart disease (IHD), type 2 diabetes (T2D), and chronic kidney disease (CKD). Markov multi-state models were used to assess the associations between the TyG index and disease transitions.
resultsAmong 377,757 participants (median age 57 years), 4949 developed NAFLD over a median follow-up of 13.6 years. Of these, 12.65% progressed to T2D, 9.11% to IHD, 8.63% to CKD, and 4.61% to IS. Elevated TyG levels significantly accelerated transitions from NAFLD to first-onset CKM disease (HR = 1.25, 95% CI 1.05-1.49), double CKM disease (HR = 1.46, 95% CI 1.19-1.80), and triple CKM disease (HR = 1.81, 95% CI 1.28-2.55). Similar progression risk increases were observed for individual CKM components: T2D (HR = 1.41, 95% CI 1.11-1.78), CKD (HR = 1.37, 95% CI 1.08-1.75), and IS (HR = 1.70, 95% CI 1.27-2.27). A J-shaped dose-response relationship was identified. Transitions risk remained pronounced among individuals with healthy sleep and regular physical activity.
conclusionsInsulin resistance independently accelerated the progression from NAFLD to CKM diseases, particularly ischemic stroke. Healthy sleep and regular physical activity failed to offset this detrimental impact.
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