Cardiometabolic & kidneyCohort study

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

BMJPublished

  • Nationwide population based cohort study
  • longitudinal

Authors' conclusion

NAFLD 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.

Study context

Population
Participants in the Korean National Health Screening Programme in 2009, with and without T2DM505,763 with T2DM
Participants
7,796,763 participants
Exposure
Grade 1 and grade 2 non-alcoholic fatty liver disease (NAFLD) vs no NAFLD, in patients with and without T2DM
Outcome
Incident CVD (MI, ischaemic stroke) or all cause death
Follow-up
Median 8.13 years

Main finding

As reported in the abstract

Five year absolute risk of CVD and all cause death · 5 years
GroupCVDAll cause death
No NAFLD, without T2DM1.03 (95% CI 1.02 to 1.04)1.25 (1.24 to 1.26)
Grade 1 NAFLD, without T2DM1.23 (1.22 to 1.25)1.50 (1.48 to 1.51)
Grade 2 NAFLD, without T2DM1.42 (1.40 to 1.45)2.09 (2.06 to 2.12)
No NAFLD, with T2DM3.34 (3.27 to 3.41)3.68 (3.61 to 3.74)
Grade 1 NAFLD, with T2DM3.94 (3.87 to 4.02)4.25 (4.18 to 4.33)
Grade 2 NAFLD, with T2DM4.66 (4.54 to 4.78)5.91 (5.78 to 6.05)

Observational data: associations, not effects.

Further findings

NAFLD prevalence by T2DM status

Grade 1 NAFLD

Grade 2 NAFLD

  • NAFLD prevalence by T2DM status: 6.49% of participants had T2DM

Incidence rate (per 1000 person years) of CVD and all cause death

Increased in the order no NAFLD, grade 1, grade 2 NAFLD; higher with T2DM than without

Original publication

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. BMJ. Published 13 February 2024. doi:10.1136/bmj-2023-076388

Summarised from the published abstract; every number is checked against it