Impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes across steatotic liver disease categories
Abstract This study investigated the effect of smoking and regular physical activity (PA) on the composite risk of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) across different steatotic liver disease (SLD) categories. We analyzed data for 1,921,310 patients with T2D...
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Nature Portfolio
2025-08-01
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| Online Access: | https://doi.org/10.1038/s41598-025-16750-7 |
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| author | So Hyun Cho Gyuri Kim Kyu-na Lee Rosa Oh Ji Yoon Kim Myunghwa Jang You-Bin Lee Sang-Man Jin Kyu Yeon Hur Kyungdo Han Jae Hyeon Kim |
| author_facet | So Hyun Cho Gyuri Kim Kyu-na Lee Rosa Oh Ji Yoon Kim Myunghwa Jang You-Bin Lee Sang-Man Jin Kyu Yeon Hur Kyungdo Han Jae Hyeon Kim |
| author_sort | So Hyun Cho |
| collection | DOAJ |
| description | Abstract This study investigated the effect of smoking and regular physical activity (PA) on the composite risk of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) across different steatotic liver disease (SLD) categories. We analyzed data for 1,921,310 patients with T2DM aged 20 years and older. The participants were categorized by SLD status, with hepatic steatosis (fatty liver index ≥ 30). Among current smokers, the adjusted hazard ratios (HR) for composite CVD events significantly increased from the 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) groups, with the highest HR observed in the ALD group (aHR, 2.14; 95% confidence interval [CI], 2.04–2.24). The ALD group without regular PA had the highest risk of composite CVD events (aHR, 1.33; 95% CI, 1.28–1.38). The highest risk of composite CVD events was found among current smokers without regular PA, with the aHR increasing in a stepwise manner from no steatosis to MASLD, MetALD, and ALD groups, with the latter showing the highest risk. Smoking and physical inactivity significantly increased the CVD risk in patients with T2DM, with the highest risk in the ALD group. |
| format | Article |
| id | doaj-art-84d75abfd33446bcb1843225c83ce98a |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-84d75abfd33446bcb1843225c83ce98a2025-08-24T11:20:07ZengNature PortfolioScientific Reports2045-23222025-08-0115111310.1038/s41598-025-16750-7Impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes across steatotic liver disease categoriesSo Hyun Cho0Gyuri Kim1Kyu-na Lee2Rosa Oh3Ji Yoon Kim4Myunghwa Jang5You-Bin Lee6Sang-Man Jin7Kyu Yeon Hur8Kyungdo Han9Jae Hyeon Kim10Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Biomedicine and Health Sciences, College of Medicine, The Catholic University of KoreaDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Statistics and Actuarial Science, Soongsil UniversityDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract This study investigated the effect of smoking and regular physical activity (PA) on the composite risk of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) across different steatotic liver disease (SLD) categories. We analyzed data for 1,921,310 patients with T2DM aged 20 years and older. The participants were categorized by SLD status, with hepatic steatosis (fatty liver index ≥ 30). Among current smokers, the adjusted hazard ratios (HR) for composite CVD events significantly increased from the 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) groups, with the highest HR observed in the ALD group (aHR, 2.14; 95% confidence interval [CI], 2.04–2.24). The ALD group without regular PA had the highest risk of composite CVD events (aHR, 1.33; 95% CI, 1.28–1.38). The highest risk of composite CVD events was found among current smokers without regular PA, with the aHR increasing in a stepwise manner from no steatosis to MASLD, MetALD, and ALD groups, with the latter showing the highest risk. Smoking and physical inactivity significantly increased the CVD risk in patients with T2DM, with the highest risk in the ALD group.https://doi.org/10.1038/s41598-025-16750-7Alcohol drinkingCardiovascular diseasesDiabetes mellitusExerciseFatty liverSmoking |
| spellingShingle | So Hyun Cho Gyuri Kim Kyu-na Lee Rosa Oh Ji Yoon Kim Myunghwa Jang You-Bin Lee Sang-Man Jin Kyu Yeon Hur Kyungdo Han Jae Hyeon Kim Impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes across steatotic liver disease categories Scientific Reports Alcohol drinking Cardiovascular diseases Diabetes mellitus Exercise Fatty liver Smoking |
| title | Impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes across steatotic liver disease categories |
| title_full | Impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes across steatotic liver disease categories |
| title_fullStr | Impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes across steatotic liver disease categories |
| title_full_unstemmed | Impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes across steatotic liver disease categories |
| title_short | Impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes across steatotic liver disease categories |
| title_sort | impact of smoking and physical activity on cardiovascular outcomes in type 2 diabetes across steatotic liver disease categories |
| topic | Alcohol drinking Cardiovascular diseases Diabetes mellitus Exercise Fatty liver Smoking |
| url | https://doi.org/10.1038/s41598-025-16750-7 |
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