Abstract
Objective: We examined the association between non-alcoholic fatty liver disease (NAFLD) markers and fasting serum immunoreactive insulin (FIRI) and urinary albumin excretion (UAE). Subjects and methods: This study comprised Periods I and II from January 2007 to May 2009, and from June 2009 to December 2011, respectively. After excluding people with ethanol intake ≥210 g/week in men and ≥140 g/week in women, 961 people (613 men, 348 women; mean age: 44 years) were included. We evaluated the fatty liver using ultrasonography score (FLUS) and measured liver enzymes. Results: The mean observation period was 25 ± 9 months. We stratified people into two groups by fasting plasma glucose (FPG) in Period I. The cutoff point between the lower FPG and higher FPG was 100 mg/dL. In regression analysis, serum alanine aminotransferase (ALT) (p < 0.001), FLUS (p < 0.001) and γ-glutamyl transpeptidase (GGTP) (p = 0.022) in Period I were independently associated with FIRI in Period II, whereas in all participants FPG was not. ALT (p < 0.001) and GGTP (p = 0.001) were also independently associated with UAE in people with FPG < 100 mg/dL in Period II. Conclusions: Some NAFLD markers were associated with FIRI and UAE independently of fasting plasma glucose.
Highlights
Several markers have been reported to be risk factors associated with cardiovascular disease and mortality
We stratified people into two groups based on fasting plasma glucose (FPG) in Period I, and the cutoff point between the lower FPG (
body mass index (BMI), HbA1c, waist circumference, systolic and diastolic blood pressure, fatty liver using ultrasonography score (FLUS), total Japanese diabetes risk score (JPDRISC) value, and levels of serum TG, total cholesterol (TC), aspartate transaminase (AST), alanine transaminase (ALT), GGTP, and ChE during Period I were significantly higher in people with FPG ≥ 100 mg/dL than those with FPG < 100 mg/dL, and serum HDL cholesterol was lower
Summary
Several markers have been reported to be risk factors associated with cardiovascular disease and mortality. The Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe (DECODE) study group reported that a high fasting serum insulin level was significantly and independently associated with cardiovascular mortality in non-diabetic men and women [1]. Increased urinary albumin excretion (UAE) has been shown to be independently associated with all-cause mortality in the general population, and the relationship was significant even at levels of albuminuria considered to be within the normal range [2]. Despite these interesting findings, it is not always possible to evaluate fasting serum insulin and UAE at routine clinical examinations, and we should look for useful predictors for those parameters. We aimed at elucidating such associations in a retrospective cohort study of Japanese people
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