Table 1_Metabolic dysfunction-associated fatty liver disease increases the risk of new-onset type 2 diabetes mellitus: a retrospective cohort study based on health check-up data.docx

Associations were analyzed using Kaplan–Meier methods and multivariable Cox regression. The primary analysis was adjusted for age, sex, and body mass index (BMI); a fully adjusted model including additional metabolic covariates was performed as a sensitivity analysis.</p>Results<p>Over a median 60-month follow-up, 22 new T2DM cases occurred. The 5-year cumulative incidence of T2DM was significantly higher in the MAFLD group than in the non-MAFLD group (18.9% vs. 5.6%, p = 0.001).

Multivariable Cox regression suggested that MAFLD was associated with an increased risk of new-onset T2DM (adjusted HR = 3.15, 95%CI: 1.58–6.28, p = 0.001 for age, sex, and BMI; a fully adjusted sensitivity analysis yielded HR = 2.71, 95%CI: 1.33–5.52, p = 0.006), with preliminary findings for both lean MAFLD (HR = 2.88, 95%CI: 1.10–7.54, based on a small subgroup of 15 participants) and overweight/obese MAFLD (HR = 2.65, 95%CI: 1.22–5.76, both from fully adjusted sensitivity models).

Sensitivity and stratified analyses were generally consistent with the primary association, although the small number of events in subgroup analyses limited the statistical power and precluded definitive conclusions.</p>Conclusion<p>Baseline MAFLD may be associated with an increased risk of new-onset T2DM within 5 years in a health check-up population, although these preliminary findings require confirmation in larger studies.

Both lean and overweight/obese MAFLD subtypes showed associations with an elevated risk of T2DM in exploratory analyses, although the finding for lean MAFLD (based on only 15 individuals and 3 T2DM events) should be considered hypothesis-generating and preliminary and requires validation in larger cohorts. Early screening and lifestyle interventions for individuals with MAFLD are of paramount clinical importance for diabetes prevention.</p>