Fatty Liver Drives Diabetes Risk Beyond Body Mass Index: An 8-Year Cohort Study.

Abstract

The aim of this study was to explore the role of body mass index and fatty liver in the incidence of diabetes. Retrospective data of railway drivers were collected and analyzed from health checks conducted between 2017 and 2024. After 8 years, 39.51% of individuals with baseline fasting glucose of 6.1 to 6.9 mmol/L developed diabetes. Fatty liver was a strong independent predictor of diabetes, whereas body mass index did not. The proportion of overweight and fatty liver among patients with diabetes increased from 0% to 42% and 51%; 50% of individuals with fatty liver developed diabetes within 6 years, all P < 0.05. This study suggests that priority should be given to interventions targeting individual metabolic disorders rather than focusing solely on weight loss.