Soft drink consumption and liver fibrosis in type 2 diabetes

Sep 28, 2026

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Soft drink consumption and liver fibrosis were examined in adults with type 2 diabetes mellitus and imaging-confirmed liver steatosis. Metabolic dysfunction–associated steatotic liver disease was highlighted as highly prevalent, with liver fibrosis identified as the strongest predictor of adverse outcomes. Dietary soft drink intake was assessed via a validated food frequency questionnaire, and liver stiffness was measured using vibration-controlled transient elastography, defining significant fibrosis by preset cut-offs.

LanguageEnglish

CategoryHealthcare

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Pages9

Reading Time23 min

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Introduction

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TYPE Original Research PUBLISHED 18 December 2025 DOI 10. 3389/fnut.2025.1726040 OPEN ACCESS EDITED BY Yannan Jin, King’s College London, United Kingdom REVIEWED BY Theodoros Androutsakos, National and Kapodistrian University of Athens, Greece Sara Taha Elazab, Mansoura University, Egypt *CORRESPONDENCE Marilena Durazzo marilena. durazzo@unito. it †These authors have contributed equally to this work and share ﬁrst authorship ‡These authors have contributed equally to this work and share last authorship RECEIVED 15 October 2025 REVISED 26 November 2025 ACCEPTED 30 November 2025 PUBLISHED 18 December 2025 CITATION Ferro A, Bollati M, Caviglia GP, Armandi A, Bellini S, Limoncelli S, Mengozzi G, Barutta F, Broglio F, Beccuti G, Bugianesi E, Durazzo Mand Gruden G (2025) Soft drink consumption and liver ﬁbrosis in type 2 diabetes. Front. Nutr. 12:1726040 . doi: 10.3389/fnut.2025.1726040 COPYRIGHT © 2025 Ferro, Bollati, Caviglia, Armandi, Bellini, Limoncelli, Mengozzi, Barutta, Broglio, Beccuti, Bugianesi, Durazzo and Gruden. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Soft drink consumption and liver ﬁbrosis in type 2 diabetes Arianna Ferro1,2†, Martina Bollati1,2†, Gian Paolo Caviglia1,3 , Angelo Armandi1,3 , Stefania Bellini1 , Selene Limoncelli4 , Giulio Mengozzi1,4 , Federica Barutta1 , Fabio Broglio1,2 , Guglielmo Beccuti1,2 , Elisabetta Bugianesi1,3 , Marilena Durazzo1*‡ and Gabriella Gruden1,5‡ 1 Department of Medical Sciences, University of Turin, Turin, Italy, 2 Division of Endocrinology, Diabetes and Metabolism, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza di Torino, Turin, Italy, 3 Division of Gastroenterology and Hepatology, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza di Torino, Turin, Italy, 4 Clinical Biochemistry Laboratory “Baldi e Riberi”, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza di Torino, Turin, Italy, 5 Division of Internal Medicine 3, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza di Torino, Turin, Italy Introduction: Metabolic dysfunction–associated steatotic liver disease (MASLD) is highly prevalent among individuals with type 2 diabetes mellitus (T2DM), and liver ﬁbrosis represents its strongest predictor of adverse outcomes. Soft drinks (SDs), a major source of added sugars and fructose, have been linked to metabolic disorders, but evidence on their relationship with liver ﬁbrosis inpatients with T2DM is limited. This study investigated the association between SDs consumption and liver ﬁbrosis in adults with both T2DM and liver steatosis. Methods: We analyzed 273 participants from the TESEO-DM cohort with imaging-documented hepatic steatosis (Controlled Attenuation Parameter, CAP ≥248 dB/m) . SDs intake was assessed using the validated EPIC food frequency questionnaire and categorized as rarely/never, 1–4 servings per month, or> 1 servings per week. Liver stiffness measurement (LSM) was assessed using vibration-controlled transient elastography and LSM >7 used as cut-off to deﬁne signiﬁcant liver ﬁbrosis. Results: In age-and sex-adjusted linear regression, SDs intake was directly associated with LSM (β = 0. 181, 95% CI: 0 .062–0. 299, p = 0.003) . The association remained signiﬁcant after adjustment for diabetes duration, total caloric intake, high-density lipoprotein cholesterol, and either body mass index (β = 0. 153, 95% CI: 0 .032–0. 274, p = 0.014) or CAP (β = 0. 150; 95% CI: 0 .028–0. 274; p = 0.017) . In logistic regression,

FAQs

What population was studied in this research?

Adults with type 2 diabetes mellitus and imaging-documented hepatic steatosis were included, using data from the TESEO-DM cohort.

How was soft drink intake measured and categorized?

Soft drink intake was assessed with the validated EPIC food frequency questionnaire and categorized as rarely/never, 1–4 servings per month, or more than 1 serving per week.

How was liver fibrosis evaluated?

Liver stiffness was measured by vibration-controlled transient elastography, with liver stiffness values above a specified cut-off used to define significant liver fibrosis.

Sep 28, 2026

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