Hepatic steatosis (FLI ≥ 60) was associated with an increased risk of myocardial infarction (HR 1.28), stroke (HR 1.41), heart failure (HR 1.17), and mortality (HR 1.41) in new-onset type 2 diabetes.
Cohort (n=139,633)
Yes
Does hepatic steatosis and/or advanced fibrosis increase the risk of cardiovascular outcomes and mortality in patients with new-onset type 2 diabetes?
In patients with new-onset type 2 diabetes, the presence of hepatic steatosis and advanced fibrosis, as assessed by non-invasive scores, is significantly associated with an increased risk of cardiovascular events and mortality.
Effect estimate: HR 1.28 (95% CI 1.14-1.44)
Absolute Event Rate: 2.96% vs 2.76%
p-value: p=<0.001
BACKGROUND: Although both type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD) are associated with increased risk of cardiovascular disease (CVD), evidence is lacking as to whether the presence of NAFLD confers an additional risk of CVD in patients with T2DM. We investigated the associations between hepatic steatosis and/or fibrosis and risk of myocardial infarction (MI), stroke, heart failure (HF), and mortality in patients with new-onset T2DM. METHODS: Using the Korean National Health Insurance dataset, we included 139,633 patients diagnosed with new-onset T2DM who underwent a national health screening from January 2009 to December 2012. Hepatic steatosis and advanced hepatic fibrosis were determined using cutoff values for fatty liver index (FLI) and BARD score. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards regression models. RESULTS: During the median follow-up of 7.7 years, there were 3,079 (2.2%) cases of MI, 4,238 (3.0%) cases of ischemic stroke, 4,303 (3.1%) cases of HF, and 8,465 (6.1%) all-cause deaths. Hepatic steatosis defined as FLI ≥ 60 was associated with increased risk for MI (HR 95% CI, 1.28 1.14-1.44), stroke (1.41 1.25-1.56), HF (1.17 1.07-1.26), and mortality (1.41 1.32-1.51) after adjusting for well-known risk factors. Compared to the group without steatosis, the group with steatosis and without fibrosis (BARD < 2) and the group with both steatosis and fibrosis (BARD ≥ 2) showed gradual increased risk for MI, stroke, HF, and mortality (all p for trends < 0.001). CONCLUSION: Hepatic steatosis and/or advanced fibrosis as assessed by FLI or BARD score were significantly associated with risk of CVD and mortality in new-onset T2DM.
Park et al. (Sat,) conducted a cohort in New-onset type 2 diabetes mellitus (n=139,633). Hepatic steatosis (FLI ≥ 60) vs. No hepatic steatosis (FLI < 30) was evaluated on Myocardial infarction (HR 1.28, 95% CI 1.14-1.44, p=<0.001). Hepatic steatosis (FLI ≥ 60) was associated with an increased risk of myocardial infarction (HR 1.28), stroke (HR 1.41), heart failure (HR 1.17), and mortality (HR 1.41) in new-onset type 2 diabetes.