Prospective Cohort of NAFLD in Saudi T2DM

This study included patients who participated in the Cohort of Non-alcoholic Fatty Liver Disease in Saudis with T2DM (the CORDIAL Study). This prospective cohort study started in 2015 and recruited patients from King Fahad Medical City (KFMC) and affiliated Primary Care Centers in Riyadh, Saudi Arabia. The cohort was approved by the Institutional Review Board at KFMC (study number: 12–344), and all patients provided written, informed consent prior to recruitment. The study was conducted in accordance with the ethical principles for medical research on human subjects adopted by the 18th World Medical Association General Assembly, and the Declaration of Helsinki 1964 and its subsequent amendments. The inclusion criteria included Saudi patients aged 18–60 years who were diagnosed with T2DM and followed up regularly in the diabetes or primary care clinics. Patients were excluded if they tested positive for hepatitis B surface antigen or had antibodies against hepatitis C virus, were diagnosed with other chronic liver diseases (e.g., hemochromatosis, primary biliary cholangitis, or autoimmune hepatitis), known to have pre-existing hepatic or extrahepatic malignancy, or were consuming >20 g of alcohol per day. The patients will be prospectively followed for 10 years and assessed for hepatic, metabolic, renal, and cardiovascular complications.