Accelerated Biological Aging is Associated With Increased Risk of T2DM in the MASLD Population

Accelerated Biological Aging is Associated With Increased Risk of T2DM in the MASLD Population: a Cohort Study

The association between biological aging and type 2 diabetes mellitus (T2DM) incidence in individuals with and without metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear.We assessed biological age by calculating phenotypic age (PhenoAge), Klemera-Doubal method (KDMAge), and homeostatic dysregulation (HDAge). To examine the association of biological ageing with the risk of T2DM, cox regression models were conducted. Furthermore, we applied survival analysis, restricted cubic spline models and population attributable fraction (PAF) to further evaluate the association between biological ageing and T2DM incidence.

Inclusion Criteria:

1. Abdominal ultrasound data available in annual health check-up records
2. At least one of the following five metabolic indicators recorded annually:

(1) Body mass index (BMI) or waist circumference (2) Blood pressure (3) Serum triglycerides (4) High-density lipoprotein cholesterol (HDL-C) (5) Fasting plasma glucose or glycated hemoglobin (HbA1c)

Exclusion Criteria:

1. Age <20 or >90 years
2. Other causes of hepatic steatosis (e.g., alcoholic liver disease or hepatitis B infection)
3. Type 2 diabetes mellitus at baseline
4. Missing baseline data for any of the following variables: systolic blood pressure, albumin, alkaline phosphatase, blood urea nitrogen, creatinine, glycated hemoglobin (HbA1c), total cholesterol, lymphocyte percentage, white blood cell count, mean corpuscular volume, uric acid, fasting plasma glucose, and red cell distribution width (RDW)