Spatiotemporal burden, risk factors, and genetic causality of non‐alcoholic fatty liver disease and type 2 diabetes mellitus comorbidity in Europe: A multi‐database analysis

This study represents the inaugural integration of GBD 2023 database with MR analysis, systematically elucidating the disease burden trends of NAFLD and T2DM in Europe. The findings precisely characterise the co-morbidity patterns of these two metabolic diseases, highlighting a synergistic effect on disease burden in Central and Eastern Europe that is highly correlated with the region's rapid socio-economic transition. Epidemiological evidence further indicates an accelerating upward trend in the incidence of these diseases among younger populations. Crucially, MR analysis identifies abdominal obesity, quantified by waist circumference, as the dominant causal link between NAFLD and T2DM. Notably, its effect magnitude significantly exceeds that of general BMI or genetic susceptibility. Based on these findings, the study emphasises an urgent need for public health and clinical practice to transition from single-disease management models to integrated metabolic care strategies. Specifically, priority should be given to interventions focused on reducing abdominal fat and implementing early screening among high-risk young populations. This strategy holds promise for effectively curbing the spread of metabolic diseases in Europe and alleviating future public health burdens.