pFIB scores for paediatric MASLD fibrosis are associated with risk of youth-onset type 2 diabetes in children with obesity
Main finding · T2DResult — go to the resultAdjusted hazard ratio 3.05 95% CI 2.17–4.28Authors' conclusion
A liver-derived composite risk score identifies a subgroup of adolescents with obesity at markedly increased short-term risk of type 2 diabetes.
Study context
- Population
- Children with obesity (aged 12.0 years at baseline), Swedish Childhood Obesity Treatment Register (BORIS, 2005–2020) linked with national registers4,856 children with obesity
- Exposure
- pFIB-6 ≥4 vs pFIB-6 <4 in children with obesity, and general population comparators
- General population comparatorsn = 23,758
- Outcome
- Incident T2D
- Follow-up
- 9-19 years of age
Methodological detailsregister-based, linked with national registers
- Register-based
- Linked with national registers
Main finding
T2D
Adjusted hazard ratio
3.05
95% CI 2.17–4.28
By group
pFIB-6 ≥4
161.7 per 10,000 person-years
CI 122.2–213.9
pFIB-6 <4
45.5 per 10,000 person-years
CI 37.8–54.7
General population comparators
1.02 per 10,000 person-years
CI 0.61–1.72
pFIB-6 ≥4vs pFIB-6 <4
aHR 3.05 (95% CI 2.17–4.28)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Prevalence of pFIB-6 ≥4 among children with obesity
- Children with obesity with a pFIB-6 ≥4
- 12.4%
T2D at 20-25 years of age
- Neither score, measured at paediatric age, predicted T2D risk at 20-25 years of age
Individual score components
- Elevated ALT and HOMA-IR were most strongly associated with T2D risk
Adipose tissue insulin resistance (independent cohort)
- Higher pFIB-6 scores were associated with greater adipose tissue insulin resistance
Original publication
pFIB scores for paediatric MASLD fibrosis are associated with risk of youth-onset type 2 diabetes in children with obesity. Diabetologia. Published 22 July 2026. doi:10.
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