Metabolic dysfunction‐associated steatotic liver disease: A superior predictor for incident type 2 diabetes over traditional criteria – NAGALA study

• Published in: Journal of diabetes investigation 2024-12, Vol.15 (12), p.1788-1796
• Main Authors: Sakai, Kimiko, Okamura, Takuro, Toyokuni, Ema, Okada, Hiroshi, Obora, Akihiro, Kojima, Takao, Hamaguchi, Masahide, Fukui, Michiaki
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Alcohol use; Body mass index; Classification; Cohort analysis; Comparative analysis; Data collection; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Fatty liver; Fatty Liver - complications; Fatty Liver - diagnosis; Fatty Liver - epidemiology; Fatty Liver - pathology; Female; Females; Follow-Up Studies; Glucose; Humans; Incidence; Japan - epidemiology; Liver diseases; Liver steatosis; Male; Males; Metabolism; Middle Aged; Multivariate analysis; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Non‐alcoholic fatty liver disease; Original; Prognosis; Regression analysis; Retrospective Studies; Risk Factors; ROC Curve; Statistical analysis; Type 2 diabetes mellitus; Ultrasonic imaging
• ISSN: 2040-1116; 2040-1124; 2040-1124
• DOI: 10.1111/jdi.14315

ABSTRACT Aims/Introduction The 2023 Delphi consensus recommended the use of new term, metabolic dysfunction‐associated steatotic liver disease (MASLD), aiming conceptual shift from the conventional non‐alcoholic fatty liver disease (NAFLD). The association between NAFLD and type 2 diabetes mellitus (T2DM) development is well known. This study aimed to examine the correlation between MASLD and T2DM development, comparing their utility as predictors. Materials and Methods This retrospective cohort study obtained data from a medical health checkup program conducted at Asahi University Hospital, Japan, between 2004 and 2021. Logistic regression analysis was used to assess the association between MASLD and incident T2DM over 5 years. To compare the predictive utility of NAFLD and MASLD, receiver operating characteristic curves were drawn, followed by area under the curve (AUC) comparisons. Results In total, 15,039 participants (59.6% males; median [interquartile range {IQR}] age, 44 [38, 50] years) were included. Out of 2,682 participants meeting the criteria for MASLD, 234 individuals (8.7%) developed T2DM. Multivariate analysis revealed a significantly elevated risk of T2DM in MASLD compared with the reference healthy group (without steatotic liver disease or cardiometabolic risk), presenting an OR of 127.00 (95% CI 40.40–399.00, P