Combined Effect of Smoking and Fatty Liver Disease on the Progression of Type 2 Diabetes: Insights from a Population-Based Cohort Study

OBJECTIVES: Fatty liver disease (FLD) is strongly linked to the occurrence of type 2 diabetes mellitus (T2DM). Insulin resistance (IR) is linked to smoking. Our study's purpose was to see how smoking and fatty liver accompanied affected the development of T2DM in the past. MATERIALS AND METHODS: We collected data from 15,464 Japanese adults aged 18 to 79 years who took part in the NAGALA research, and our team utilized a Cox proportion risk model to look at the combination effect of FLD and smoking status on the incidence of T2DM. Participants were separated into three categories: nonsmokers, ex-smokers, and current smokers. An abdominal ultrasound was used to diagnose FLD. RESULTS: 384 subjects had T2DM after a median follow-up of 5.4 years. In comparison to the other groups, current FLD smokers had a greater chance of developing T2DM. Ex-smokers and present FLD smokers, on the other hand, had no significant difference in their likelihood of acquiring T2DM. When compared to ex-smokers and nonsmokers without FLD, current smokers with FLD had a considerably greater chance of acquiring T2DM. Furthermore, the risk of T2DM among nonsmokers, ex-smokers with FLD, and current smokers without FLD was not statistically significant. CONCLUSIONS: In order to prevent the progression of T2DM, we should recognize that smoking status may vary in FLD.