Differences in the risk of fatty liver for onset of impaired fasting glucose according to baseline plasma glucose levels.

Abstract

It remains unclear whether fatty liver is a risk factor for the onset of abnormal glucose tolerance in any patient. The objective of this study was to clarify the relationship between fatty liver and the onset of impaired fasting glucose according to baseline fasting plasma glucose (FPG) levels. This community-based longitudinal cohort study included 7,905 adults (3,863 men, 4,042 women; age range, 18-80years) who had at least two annual checkups between 2003 and 2013. Those with FPG levels ≥110mg/dl, taking anti-diabetic agents, and/or testing positive for hepatitis B surface antigen or anti-hepatitis C virus antibody were excluded, leaving 7,203 participants eligible for inclusion. All participants were divided into quartiles derived from their FPG levels at baseline. FPG ≥110mg/dl during the observation period was defined as onset of IFG. Onset of IFG was found in 7.7% of men and 2.1% of women (p<0.001). After adjusting for age, body mass index, systolic blood pressure, triacylglycerol, high-density lipoprotein cholesterol, uric acid, creatinine, family history of diabetes, alcohol consumption, and current smoking, a positive association was found between fatty liver and the onset of IFG in both sexes with the highest quartile of FPG levels [men: adjusted hazard ratio (aHR) 1.823, 95% confidence interval (CI) 1.316-2.534, p<0.001; women: aHR 2.016, 95% CI 1.117-3.6, p=0.02]. Our results suggest that fatty liver is independently associated with an increased risk of developing IFG in individuals with high FPG.