Importantly, patients with both high Fib-4 (≥1.3) and high TyG (≥9.03) had the greatest SLVD risk (OR = 7.58), whereas advanced fibrosis alone was not significant.<h4>Conclusions</h4>Fib-4 index and TyG index are independent predictors of SLVD in T2DM, and their coexistence exerts a synergistic effect. This evidence concerns the gene FBL and type 2 diabetes mellitus.