Abstract
Fatty liver is associated with incident diabetes, and the fatty liver index (FLI) is a surrogate marker for non-alcoholic fatty liver disease (NAFLD). We aimed to determine whether or not FLI was associated with incident diabetes in relation to obesity and prediabetic levels in the general Japanese population. This was a retrospective study using the Japanese health check-up database of one health insurance from FY2015 to FY2018. This study included 28,991 individuals with prediabetes. First, we stratified all participants into two groups: "high-risk," comprising patients with HbA1c >6.0%, and "standard," comprising the rest. Subsequently, we divided them into four groups according to FLI (<30 or not) and obesity (BMI <25 kg/m2 or not). Subsequently, the incidence rate of diabetes was compared among the groups after 3 years of follow-up using multiple logistic regression models after adjusting for potential confounders. After 3 years of follow-up, 1,547 new cases of diabetes were found, and the cumulative incidence was 2.96% for the standard group and 26.1% for the high-risk group. In non-obese individuals, odds ratios (95% confidence interval) for FLI ≥30 versus FLI <30 were: 1.44 (1.09-1.92) for the standard group and 1.42 (0.99-2.03) for the high-risk group. In the high-risk group, obesity (BMI ≥25 kg/m2) but FLI <30 was not a risk factor for developing diabetes. Although high FLI is generally considered to be a risk factor for developing diabetes, obesity might have been a confounding factor. However, the present study showed that high FLI is a risk factor for the development of diabetes, even in non-obese individuals. Our results include suggestion to develop a screening tool to effectively identify people at high risk of developing diabetes from the population (especially non-obese prediabetes) who are apparently at low health risk and are unlikely to be targeted for health guidance.
Highlights
Non-alcoholic fatty liver disease (NAFLD) refers to a fatty liver without a history of excessive alcohol consumption or liver disease
Fatty liver is associated with incident diabetes, and the fatty liver index (FLI) is a surrogate marker for non-alcoholic fatty liver disease (NAFLD)
The present study showed that high FLI is a risk factor for the development of diabetes, even in non-obese individuals
Summary
Non-alcoholic fatty liver disease (NAFLD) refers to a fatty liver without a history of excessive alcohol consumption or liver disease. It is becoming a common chronic liver disease worldwide. Liver biopsy is the gold standard for diagnosing NAFLD. Since it is an invasive procedure, abdominal ultrasonography is clinically used for the diagnosis. Fatty liver is associated with incident diabetes, and the fatty liver index (FLI) is a surrogate marker for non-alcoholic fatty liver disease (NAFLD). We aimed to determine whether or not FLI was associated with incident diabetes in relation to obesity and prediabetic levels in the general Japanese population
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
