MRI-derived liver fat levels accurately predicted diabetes risk in adults with obesity.

The study analyzed 683 participants aged 18–65 years (mean, 33; 18% men).

Each 1% increase in liver fat (PDFF) raised the likelihood of prediabetes or diabetes.

Severe steatosis (PDFF ≥25%) tripled the risk of abnormal glucose metabolism.

Liver enzymes ALT and AST explained 39% and 27% of the link, respectively.

In validation, mean PDFF was higher in patients with diabetes (19.7% vs 12.9%).

Findings were limited by cross-sectional design and obesity-only cohort.