Metabolically healthy obesity is associated with an increased risk of diabetes independently of nonalcoholic fatty liver disease (original) (raw)
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Diabetes research and clinical practice, 2017
To evaluate whether variable fatty liver status over time influence the risk of type 2 diabetes differently. We analyzed the data from 7849 subjects without type 2 diabetes who underwent comprehensive health check-ups annually for 5 years. All subjects had an abdominal ultrasonography annually. The risk of incident diabetes was assessed in individuals with sustained non-alcoholic fatty liver disease (NAFLD), individuals with changed fatty liver status (intermittent NAFLD group), and individuals who did not have NAFLD (never NAFLD group) during the study period. A subgroup analysis was done in subjects of the intermittent NAFLD group. Incident diabetes was compared according to the number of time diagnosed as NAFLD by annual ultrasonography. During the mean follow-up of 4 years, subjects in the sustained NAFLD group had a HR of 1.50 (95% CI 1.13-1.98) for the development of diabetes compared with those in the never NAFLD group, whereas the risk was not higher in the intermittent NAFL...
Combined influence of nonalcoholic fatty liver and body size phenotypes on diabetes risk
Cardiovascular diabetology, 2015
We aimed to determine the association between nonalcoholic fatty liver disease (NAFLD) and diabetes risk among body size phenotypes which was based on cross-classification of body mass index (BMI) categories (normal or overweight/obesity) and metabolic status (metabolically health or metabolically at-risk). We conducted a cross-sectional analysis using a cohort of 10,761 apparently healthy Chinese adults who underwent comprehensive health checkups including abdominal ultrasonography. Subjects were classified as metabolically at-risk by having any two of the following, consistent with the Adult Treatment Panel-III metabolic syndrome definition: (1) systolic/diastolic blood pressure ≥130/85 mmHg, (2) triglycerides ≥1.7 mmol/L, (3) fasting blood glucose ≥5.6 mmol/L, (4) HDL-cholesterol ≥1.0/1.3 mmol/L for men/women. Among participants without metabolically at-risk, multivariate-adjusted odds ratios (ORs) for diabetes from NAFLD compared with those without NAFLD in the normal-weight (BM...
Liver International, 2009
Background/Aims: Diabetic patients have an increased prevalence and severity of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate the prevalence and the factors associated with the presence of ultrasonographic NAFLD in type-2 diabetic individuals.Methods: In a cross-sectional design study, 180 type-2 diabetic patients were submitted to a complete clinical and laboratory evaluation and abdominal ultrasonography for NAFLD detection and grading. Statistical analysis included bivariate tests, analysis of variance (anova, for increasing severity of steatosis) and multivariate logistic regression.Results: The prevalence of ultrasonographic NAFLD was 69.4% [95% confidence interval (CI): 58.3–82.7%]. Patients with NAFLD were more obese, had a higher waist circumference and serum triglyceride and alanine aminotransferase (ALT) levels than those without steatosis. Neither diabetic degenerative complication, nor glycaemic control was associated with liver steatosis. On multivariate analysis, a high serum triglycerides level [>2.82 mmol/L, odds ratio (OR): 3.7–4.1, 95% CI: 1.2–13.3] and a high-normal ALT level (≥40 U/L, OR: 2.5–2.7, 95% CI: 1.2–5.9) were independently associated with hepatic steatosis, together with either the presence of obesity (OR: 7.1, 95% CI: 3.0–17.0) or of increased waist circumference (OR: 4.8, 95% CI: 1.9–12.2).Conclusions: Type-2 diabetic patients have a high prevalence of ultrasonographic NAFLD and its presence is associated with obesity, mainly abdominal, hypertriglyceridaemia and high-normal ALT levels. Non-alcoholic fatty liver disease in diabetic patients may develop and progress independent of the diabetes progression itself.
International Journal of Advances in Medicine, 2017
Background: Non-alcoholic fatty liver disease (NAFLD) is a distinct hepatic condition that is strongly associated with insulin resistance and type 2 Diabetes Mellitus (T2DM). This study was designed to assess the magnitude of NAFLD and its concomitant risk factors among patients with T2DM.Methods: In a hospital based observational descriptive study, 150 patients with T2DM were submitted to a complete clinical and laboratory evaluation; abdominal ultrasonography for NAFLD detection and grading. Patients with known chronic liver disease and history of alcohol intake were excluded. They were divided into fatty and non-fatty liver group: evaluated, compared and statistical analysis done.Results: Out of 150 patients with T2DM, 104 (69.33%) had fatty liver on USG. 42.67% had grade 1, 24% had grade 2, and the remaining 2.67% had grade 3 fatty changes in liver. The severity of NAFLD increased with increasing age (r-value = +0.554, p<0.001). Statistically significant difference in Body Ma...
Atherosclerosis, 2009
Backgrounds: Nonalcoholic fatty liver disease (NAFLD) has been linked to cardiovascular disease (CVD) but it is largely unknown if such a relationship between NAFLD and CVD risk relates to severity of liver disease or if it is independent. We aimed to study the severity of NAFLD in a well characterized non-obese population and to compare this to prevalence of CVD risk factors and Framingham risk score. Methods: This study included 30,172 subjects. Based on the presence or absence of steatosis on ultrasound and serum alanine aminotransferase (ALT), subjects were divided into controls, an increased serum ALT group without steatosis and a group with presumed nonalcoholic fatty liver disease (NAFLD), which included a steatosis alone group and a group with presumed nonalcoholic steatohepatitis (NASH) with steatosis and an elevated ALT. Results: The odds ratio for 10-year risk by total Framingham risk scores ≥10% was 5.3 times higher in NASH groups. The prevalence of diabetes, hypertension, elevated CRP and metabolic syndrome were all increased up to 15-fold over controls, independent of age, BMI, smoking and exercise habits. Overall CVD risk was significantly greater in NASH than in either steatosis or raised ALT alone. Conclusion: Young, non-obese subjects with NAFLD are at significantly increased CVD risk, especially those with NASH. As well as specific therapy for liver disease, a diagnosis of NAFLD should lead to targeted risk assessment and risk factor modification.
PloS one, 2017
The aim of this study is to examine the bidirectional association between nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). The data was derived from the Dongfeng-Tongji cohort study, which was established in 2008 and followed until October 2013. NAFLD was classified as none, mild, moderate/severe based on ultrasound examination. The analysis to examine the association between NAFLD and incident T2DM risk included 18,111 participants free of diabetes at baseline and the duration of follow-up was 4.60 ± 0.60 years. Cox proportional regression model was used to calculate the hazard ratio (HR) for the association. The analysis to investigate the association between T2DM and incident NAFLD risk included 12,435 participants free of NAFLD at baseline. Logistic regression model was used to calculate the odd ratio (OR) of NAFLD. Compared with those without NAFLD, individuals with mild or moderate/severe NAFLD had a monotonic elevated risk of developing T2DM (HR: ...
Backgroun: Type 2 diabetes mellitus (T2DM) and Nonalcoholic fatty liver disease (NAFLD) have risen globally to epidemic proportions. The study was aimed to determine the prevalence of NAFLD and its association with cardiometabolic risk factors in T2DM subjects. Method: In a case control study, 212 consecutive, T2DM subjects with age ≥ 30 years, were evaluated from December 2017 to December 2018 at Mahatma Gandhi Medical College &Hospital, Jaipur, Rajasthan. Subjects with history of significant alcohol consumption, evidence of cirrhosis, hepatotoxic drugs, and other known causes of fatty liver were excluded. The T2DM subjects were divided into (1) NAFLD -patients with USG evidence of fatty changes in the liver (2) Non-NAFLDpatients without any USG evidence of fatty changes in the liver. Coronary artery disease was screened by any past medical history of CAD or electrocardiographic or angiography evaluation. Continuous variables were expressed as mean with standard deviation.
International Journal of Advanced Multidisciplinary Research, 2017
Background: NAFLD is a clinicopathologic syndrome that is closely correlated to visceral obesity, dyslipidemia, insulin resistance, and type 2 diabetes, thus suggesting that NAFLD is another feature of the metabolic syndrome. The pathophysiology of non-alcoholic fatty liver disease involves insulin resistance, which causes hepatic steatosis, a process enhanced in patients with type 2 diabetes mellitus and/or obesity. Materials and Methods: This study was conducted in Department of Medicine and Department of Radiology, GMC, Kannauj. This was a Cross-sectional study done over a period of 18 months. The study include admitted patients having fatty liver finding on ultrasound and patients having any history of alcohol abuse and viral hepatitis were excluded. Sample size was 65. Results: Prevalence of dyslipidemia was 63.4% among diabetics as compared to 16.7%among non-diabetics. Statistically, this difference was significant (p<0.001).Similarly, mean FBS and PP BS levels were also significantly higher among patients with dyslipidemia as compared to those not having dyslipidemia (p<0.05). Conclusion: In present study prevalence of dyslipidemia with NAFLD-diabetes mellitus in cohort was found to statistically significant (p<0.001), which emphasizes that dyslipidemia is added disadvantage to precipitate non alcoholic fatty liver disease.
Nonalcoholic Fatty Liver Disease Is a Risk Factor for Type 2 Diabetes in Middle-Aged Japanese Men
Diabetes Care, 2007
OBJECTIVE—To determine the association between nonalcoholic fatty liver disease and the risk for development of diabetes. RESEARCH DESIGN AND METHODS—We conducted an observational cohort study in male workers ≥40 years old in a Japanese company from 1997 to 2005. We excluded workers with alcohol intake ≥20 g/day and those with impaired glucose tolerance by a 75-g oral glucose tolerance test. The remaining 3,189 workers were classified into fatty liver (FL) and non-FL group based on the findings of abdominal ultrasonography. Both groups were followed for the development of diabetes. Hazard ratio (HR) was determined in Cox proportional hazard analysis. A nested case-control study was conducted to determine the odds ratio (OR). RESULTS—The average age of participants was 48.0 years at the entry, and the average follow-up period was 4.0 years. The incidence of diabetes in the FL group was 2,073 per 100,000 person-years (65 cases), whereas 452 per 100,000 person-years (44 cases) in the n...