Combined impact of prediabetes and fatty liver index on cardiometabolic outcomes and mortality in middle aged adults: a nationwide cohort study
Authors' conclusion
The coexistence of prediabetes and FLI ≥ 60, which is a surrogate marker of hepatic steatosis, demonstrated a combined effect, additively increasing the risk of incident DM, composite MACE, and all-cause mortality in middle-aged adults.
Study context
- Population
- Middle-aged adults aged 40 to 65 years without history of DM or CVD
- Participants
- 1,182,751 adults
- Exposure
- Prediabetes and/or FLI ≥ 60 vs normoglycemia with FLI < 60
- Outcome
- Incident DM, composite major adverse cardiovascular events (MACE) and all-cause mortality
Main finding
As reported in the abstract
Incident DM, composite MACE, all-cause mortality (adjusted)
Estimate (95% CI)
Prediabetes with FLI < 60
OR (incident DM) 3.75(3.69–3.81)
Normoglycemia with FLI ≥ 60
OR (incident DM) 2.35(2.29–2.42)
Prediabetes with FLI ≥ 60
OR (incident DM) 6.80(6.62–6.98)
Prediabetes with FLI < 60
OR (composite MACE) 1.02(1.00–1.05)
Normoglycemia with FLI ≥ 60
OR (composite MACE) 1.23(1.17–1.28)
Prediabetes with FLI ≥ 60
OR (composite MACE) 1.27(1.21–1.33)
Prediabetes with FLI < 60
OR (all-cause mortality) 1.12(1.08–1.15)
Normoglycemia with FLI ≥ 60
OR (all-cause mortality) 1.51(1.43–1.59)
Prediabetes with FLI ≥ 60
OR (all-cause mortality) 1.69(1.60–1.79)
Observational data: associations, not effects.
Further findings
Baseline prevalence
- Diagnosed with prediabetes
- 24.6%
- FLI ≥ 60
- 8.8%
Original publication
Combined impact of prediabetes and fatty liver index on cardiometabolic outcomes and mortality in middle aged adults: a nationwide cohort study. Cardiovasc Diabetol. Published 10 July 2025. doi:10.
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