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Published on: November 11, 2025
Prediabetes phenotypes and the development and regression of metabolic dysfunction-associated fatty liver disease: A
1Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, 210009 Nanjing, China.
Aims:
Prediabetes is associated with metabolic dysfunction-associated fatty liver disease (MAFLD), but few studies have assessed the impact of prediabetes phenotypes on the development and regression of MAFLD. We aimed to examine these associations.
Methods:
This prospective cohort study included 4768 participants with prediabetes and normal glucose tolerance (NGT) who were followed-up for approximately 3 years. Prediabetes was classified as an isolated glucometabolic defect (isolated impaired fasting glucose [IFG], impaired glucose tolerance [IGT], or impaired hemoglobin A1c [IA1c]), two glucometabolic defects (IFG + IGT, IFG + IA1c, or IGT + IA1c), and all three glucometabolic defects (IFG + IGT + IA1c). Their associations with the development and regression of MAFLD were assessed using multivariable logistic regression.
Results:
Among 4768 participants, 2687 were with MAFLD and 2081 were without. Compared with NGT, the multivariable-adjusted odds of incident MAFLD were increased by 45% (95% CI 1.09-1.93) and 92% (95% CI 1.13-3.26) among participants with two and three glucometabolic defects, respectively. In contrast, the odds of MAFLD regression were decreased by 38% (95% CI 0.46-0.82) and 62% (95% CI 0.23-0.61), correspondingly.
Conclusion:
Greater numbers of glucometabolic defects were associated with higher odds of incident MAFLD but lower odds of MAFLD regression in prediabetes.
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