Association between multifactorial control and excess risk of liver diseases in type 2 diabetes: a prospective cohort study
Authors' conclusion
Patients with type 2 diabetes who had more controlled risk factors showed progressively lower excess risk of severe MASLD and MALO. Comprehensive interventions targeting multiple risk factors may be associated with reduced liver lesions in patients with type 2 diabetes.
Study context
- Population
- UK Biobank participants; T2D patients categorised by number of risk factors in guideline-recommended ranges (diet, smoking, drinking, exercise, sedentary behaviour, BMI, HbA1c, blood pressure, LDL-C)
- Participants
- 307,688 participants
- Exposure
- T2D by number of controlled risk factors vs no diabetes
- Outcome
- Severe MASLD and major adverse liver outcomes (MALO)
- Follow-up
- Median (IQR) 12.5 (11.8-13.2) years
Main finding
As reported in the abstract
Severe MASLD
Each group vs without diabetesHazard ratio (95% CI)
T2D, 0–2 controlled risk factors
5.44(4.09–7.25)
T2D, 3 controlled risk factors
4.47(3.59–5.57)
T2D, 4 controlled risk factors
4.16(3.49–4.96)
T2D, 5 controlled risk factors
3.91(3.28–4.66)
T2D, 6 controlled risk factors
3.50(2.80–4.38)
T2D, 7–9 controlled risk factors
2.61(1.92–3.56)
Observational data: associations, not effects.
Further findings
| Outcome | T2D | Without diabetes | HR (95% CI) | |
|---|---|---|---|---|
| Severe MASLD incidence, T2Dvs no diabetes | 3.9% | 0.9% | 3.93 (3.56–4.33) | |
| 0.20.5125Hazard ratio (log scale) |
Major adverse liver outcomes (MALO)
- Similar patterns were observed in the analysis of MALO
Original publication
Association between multifactorial control and excess risk of liver diseases in type 2 diabetes: a prospective cohort study. BMJ Open Diabetes Res Care. Published 8 September 2025. doi:10.
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