Abstract
The aim of the current study was to evaluate the association between changes in non-alcoholic fatty liver disease (NAFLD) over time and risk of incident diabetes mellitus (DM). In total, 3047 subjects without underlying DM were followed up for 14 years from the Anseong-Ansan cohort. NAFLD status was determined biennially using the hepatic steatosis index (HSI), and subjects were clustered into seven groups according to changes in HSI, body mass index (BMI), and homeostatic model assessment of insulin resistance (HOMA-IR): none, persistent, transient, transient resolved, resolved, incident, and recurrent NAFLD (Groups 1–7, respectively). Predictive abilities were compared between the dynamics of HSI and single time points. Regarding the changes in HSI, the risk of incident DM was highest in Group 2 (hazard ratio [HR] 2.710; P < 0.001), followed by Groups 7 (HR 2.062; P < 0.001) and 3 (HR 1.559; P = 0.027). The predictive ability for DM was powerful in order of HOMA-IR, HSI and BMI. The dynamics of NAFLD were less predictive of incident DM than single time-point NAFLD. In conclusion, NAFLD is more useful than BMI in predicting incident DM. However, NAFLD status at single time points can better predict incident DM than dynamic changes in HSI.
Highlights
The aim of the current study was to evaluate the association between changes in non-alcoholic fatty liver disease (NAFLD) over time and risk of incident diabetes mellitus (DM)
The Korea Disease Control and Prevention agency started a large-scale cohort project called the Korean Genome and Epidemiology Study (KoGES) in 2001 to investigate the genetic and environmental factors related to chronic diseases such as DM, hypertension, obesity, metabolic syndrome, and cardiovascular disease (CVD), which are common among Koreans
Even though it may be simple and easy to evaluate the risk of DM or CVD development based on the state of hepatic steatosis at any time point, it may not reflect the dynamic changes in hepatic steatosis status in detail during long-term follow-up
Summary
The aim of the current study was to evaluate the association between changes in non-alcoholic fatty liver disease (NAFLD) over time and risk of incident diabetes mellitus (DM). Even though it may be simple and easy to evaluate the risk of DM or CVD development based on the state of hepatic steatosis at any time point, it may not reflect the dynamic changes in hepatic steatosis status in detail during long-term follow-up. For these reasons, if patients with NAFLD are classified into well-defined groups and stratified as per the changes in hepatic steatosis status over time, differentiated intervention can be provided for each group in clinical practice
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