ECEESPE2025 ePoster Presentations Diabetes and Insulin (245 abstracts)
Impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes with metabolic dysfunction-associated steatotic liver disease: a nationwide study
So Hyun Cho 1 , Gyuri Kim 1 , Kyu-na Lee 2 , Rosa Oh 1 , Ji Yoon Kim 1 , Myunghwa Jang 1 , You-Bin Lee 1 , Sang-Man Jin 1 , Kyu Yeon Hur 1 , Kyungdo Han 3 & Jae Hyeon Kim 1
1Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Medicine, Seoul, South Korea; 2The Catholic University of Korea, Department of Biomedicine & Health Sciences, College of Medicine, Seoul, South Korea; 3Soongsil University, Department of Statistics and Actuarial Science, Seoul, South Korea
JOINT1661
Background: This study investigated the effects of smoking and regular physical activity (PA) on the risk of composite cardiovascular disease (CVD) outcomes in type 2 diabetes mellitus (T2DM) patients across different steatotic liver disease (SLD) categories.
Methods: We used a health examination database from 2015 to 2016, with follow-up data for 1,921,310 patients aged 20 years and older with T2DM. Participants were categorized based on SLD status where hepatic steatosis was defined as a fatty liver index (FLI)≥30. Cox analyses were used to analyze the association between smoking, regular PA and the risk of composite CVD event, myocardial infarction (MI), ischemic stroke, and cardiovascular mortality.
Results: Among current smokers in each SLD group, the adjusted hazard ratios (HR) for composite CVD events significantly increased from no steatosis to metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related steatotic liver disease (MetALD), and alcohol-related liver disease (ALD), with the highest HR observed in ALD (aHR, 2.14; 95% CI, 2.04–2.24). The ALD group without regular PA had the highest risk of composite CVD event (aHR, 1.33; 95% CI, 1.28–1.38). The highest risk of composite CVD event was found among current smokers without regular PA, with the aHR increasing in a stepwise manner from no steatosis to MASLD, MetALD, and ALD, the latter showing the highest (aHR, 2.67; 95% CI, 2.53–2.82).
Conclusion: Smoking and physical inactivity significantly increase CVD risk in T2DM patients, with the highest risk observed in the ALD group, underscoring the need for targeted lifestyle modifications, including smoking cessation, regular PA, and alcohol abstinence, to reduce CVD risk in this high-risk population.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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