我们研究了代谢功能障碍相关脂肪肝病 (MASLD) 和 2 型糖尿病 (T2D) 联合诊断对患者预后的影响。利用全球联合研究网络 TriNetX（n = 1.14 亿），我们进行了两项回顾性研究队列研究，使用事件时间分析。分析1 将MASLD 与T2D 与单独MASLD 进行比较；分析2 将带有MASLD 的T2D 与单独的T2D 进行了比较。使用贪婪最近邻 (calliper .1) 的倾向得分匹配平衡了队列 (1:1) 的显着协变量。主要结局是 5 年以上的心血管、肝脏、糖尿病相关和癌症事件。分析 1 (n = 95 275)：合并诊断 T2D 显着增加缺血性心脏病 (IHD) 的风险（HR 1.39；CI：缺血性中风（HR 1.34，1.44），缺血性中风（HR 1.45；CI：1.35，1.56），心力衰竭（HR 1.42；CI：1.36，1.49），心房颤动（HR 1.09；CI：1.03，1.16），肝细胞癌（HR 1.96；CI：1.36，1.49）。 MASLD 诊断后 5 年内发生 CI：1.69，2.27）、胰腺癌（HR 1.25；CI：1.06，1.48）和肝脏相关并发症。分析 2 (n = 15 208)：合并诊断 MASLD 显着增加全因死亡风险 (HR 1.11; CI: 1.02, 1.22)、IHD (HR 1.181; CI: 1.08, 1.29)、肝细胞死亡 (HR 50.31) ; CI: 6.94, 364.72)、胰腺癌 (HR 1.78; CI: 1.12, 2.84)、乳腺癌 (HR 1.43; CI: 1.09, 1.88) 和肾癌 (HR 2.01; CI: 1.24, 3.26) 和糖尿病神经病变 (HR 1.17；CI：1.09，1.27) 自二甲双胍开始使用起 5 年以上。T2D 显着增加 MASLD 患者发生心血管、恶性肿瘤和肝脏相关结局的风险。 MASLD 对 T2D 患者的影响虽然不那么显着，但仍然会增加死亡、缺血性心脏病、恶性肿瘤和周围神经病变的风险。© 2024 作者。约翰·威利 (John Wiley) 出版的《肝脏国际》

We examined the impact of a co-diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes (T2D) on patient outcomes.Using TriNetX, a global federated research network (n = 114 million), we undertook two retrospective cohort studies, using time-to-event analysis. Analysis 1 compared MASLD with T2D to MASLD alone; analysis 2 compared T2D with MASLD to T2D alone. Propensity score matching using greedy nearest neighbour (calliper .1) balanced the cohorts (1:1) for significant covariates. Primary outcomes were cardiovascular, liver, diabetes-related, and cancer events over 5 years.Analysis 1 (n = 95 275): a co-diagnosis of T2D significantly increased the risk of ischaemic heart disease (IHD) (HR 1.39; CI: 1.34, 1.44), ischaemic stroke (HR 1.45; CI: 1.35, 1.56), heart failure (HR 1.42; CI: 1.36, 1.49), atrial fibrillation (HR 1.09; CI: 1.03, 1.16), hepatocellular carcinoma (HR 1.96; CI: 1.69, 2.27), pancreatic cancer (HR 1.25; CI: 1.06, 1.48) and liver-related complications over 5 years from MASLD diagnosis. Analysis 2 (n = 15 208): a co-diagnosis of MASLD significantly increased risk of all-cause mortality (HR 1.11; CI: 1.02, 1.22), IHD (HR 1.181; CI: 1.08, 1.29), hepatocellular (HR 50.31; CI: 6.94, 364.72), pancreatic (HR 1.78; CI: 1.12, 2.84), breast (HR 1.43; CI: 1.09, 1.88) and renal cancer (HR 2.01; CI: 1.24, 3.26), and diabetic neuropathy (HR 1.17; CI: 1.09, 1.27) over 5 years from metformin initiation.T2D significantly potentiates the risk of cardiovascular, malignancy and liver-related outcomes in people with MASLD. The effect of MASLD on people with T2D, although less dramatic, still potentiated risk of death, IHD, malignancy and peripheral neuropathy.© 2024 The Author(s). Liver International published by John Wiley & Sons Ltd.