Joint association of non-alcoholic fatty liver disease and chronic kidney disease with risk of cardiovascular diseases and all-cause mortality in new-onset diabetes mellitus patients.

BACKGROUND AND AIMS: Diabetes mellitus (DM) commonly coexists with non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD), and when combined with these two conditions, the risk of all-cause mortality and developing cardiovascular diseases (CVD) increases. The present community-based cohort study aimed to elucidate the combined effect of NAFLD and CKD on CVD and mortality risks in new-onset DM patients.

METHODS AND RESULTS: After the exclusion of participants failing to meet the inclusion criteria, 11,328 eligible participants (mean age: 58.52 ± 10.82 years) were included. The participants were divided into no NAFLD/no CKD, NAFLD only, CKD only, and NAFLD/CKD groups. Multivariate Cox proportional hazard model was used to analyze the joint association of NAFLD and CKD with risk of CVD and all-cause mortality in new-onset DM patients. After adjusting for confounding factors, we observed that compared with the noNAFLD/noCKD group, concurrent NAFLD/CKD exhibited HRs (95 % CI) for the occurrence of CVD and all-cause mortality of 1.43 (1.18-1.74) and 1.21 (1.01-1.45), respectively, among the participants with new-onset DM.

CONCLUSION: New-onset DM complicated with NAFLD and CKD further increases the risk of CVD. Moreover, CKD risk impact may exceed that of NAFLD. These risks could be age-dependent, and antihypertensive and lipid-lowering treatments might mitigate NAFLD and CKD's effects on CVD and all-cause mortality. These findings could provide clinically meaningful evidence for the emphasized screening of NAFLD and CKD in new-onset diabetic patients.