Assessment of the fatty liver index as an indicator of hepatic steatosis for predicting incident diabetes independently of insulin resistance in a Korean population

Jung, Chang Hee; Lee, Wookjin; Hwang, Jenie Yoonoo; Yu, Jae Hong; Shin, Mi-Seon; Lee, M. J.; Jang, Jung Eun; Leem, Jaechan; Park, J. Y.; Kim, Hoon Yub

doi:10.1111/dme.12104

Cited by 36 publications

(37 citation statements)

References 30 publications

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“…Anthropometric correlates for central obesity, fasting triglycerides and GGT levels are utilized in the fatty liver index commonly used in epidemiological studies, which along with its sex-specific derivative, the lipid accumulation product, accurately predicts the presence of hepatic steatosis, and could help clinicians identify patients at increased cardiometabolic risk eligible for further diagnostic evaluation and for whom suitable lifestyle-based interventions may be indicated [34][35][36][37] . Subsequently developed models such as the NAFLD liver fat score [38] substitute GGT for the AST/ALT ratio (AAR) in addition to incorporating clinical or biochemical markers of IR.…”

Section: Composite Diagnostic Models For Hepatic Steatosismentioning

confidence: 99%

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Luckhoff

Kruger

Kotze

2015

WJH

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Heterogeneity in clinical presentation, histological severity, prognosis and therapeutic outcomes charac teristic of nonalcoholic fatty liver disease (NAFLD) necessitates the development of scientifically sound classification schemes to assist clinicians in stratifying patients into meaningful prognostic subgroups. The need for replacement of invasive liver biopsies as the standard method whereby NAFLD is diagnosed, graded and staged with biomarkers of histological severity injury led to the development of composite prognostic models as potentially viable surrogate alternatives. In the present article, we review existing scoring systems used to (1) confirm the presence of undiagnosed hepatosteatosis; (2) distinguish between simple steatosis and NASH; and (3) predict advanced hepatic fibrosis, with particular emphasis on the role of NAFLD as an independent cardiometabolic risk factor. In addition, the incorporation of functional genomic markers and application of emerging imaging technologies are discussed as a means to improve the diagnostic accuracy and predictive performance of promising composite models found to be most appropriate for widespread clinical adoption. Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries have entered the clinical domain as potentially viable alternatives. Lifestylebased intervention remains the cornerstone of treatment in patients with NAFLD. The widespread clinical adoption of composite diagnostic and predictive models could however prove useful in informing clinical and therapeutic decision making with the goal of adding value to patient care across the NAFLD spectrum.Lückhoff HK, Kruger FC, Kotze MJ. Composite prognostic models across the non-alcoholic fatty liver disease spectrum:

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Section: Composite Diagnostic Models For Hepatic Steatosismentioning

confidence: 99%

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Luckhoff

Kruger

Kotze

2015

WJH

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“…The National Health and Nutrition Survey reported that approximately 9.5 million people were strongly suspected as having DM, and a further 11.0 million people were possible candidates for having DM19. However, a previous study in Asian populations did not classify prediabetes among subjects without DM16. Previous studies in Japan did not include subjects with impaired glucose tolerance (IGT) and IFG9,10; but nevertheless, there were 20.5 million people at high risk of having diabetes.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the fatty liver index as a predictor for the development of diabetes among insurance beneficiaries with prediabetes

Nishi

Babazono

Maeda

et al. 2014

J of Diabetes Invest

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Aims/IntroductionNon-alcoholic fatty liver disease (NAFLD) is the most common liver disease in developed countries, and it was required to monitor patients with prediabetes. However, there have been few reports establishing the risk for diabetes mellitus (DM) among patients with prediabetes. The purpose of the present study was to evaluate the effect of NAFLD on the progression of DM among insurance beneficiaries with prediabetes, using data from specific health check-ups and the fatty liver index (FLI).Materials and MethodsWe used a retrospective cohort study that enrolled 967 insurance beneficiaries with prediabetes who had rarely drunk or could not drink alcohol, or whose alcohol consumption was <19 g/day from two health insurance societies. We divided insurance beneficiaries into FLI <30, intermediates FLIs and FLI ≥60, and compared the incidence rate of DM among the groups after 3 years' follow up, using multiple logistic regression models.ResultsDuring 3 years' follow up, progression of diabetes was seen in 65 men (11.5%) and 24 women (6.0%). Logistic regression analyses showed that those with NAFLD had significantly higher risks of developing DM; this was the case in both men (odds ratio 2.68, 95% confidential interval 1.29–5.56) and women (odds ratio 10.35, 95% confidential interval 3.22–33.31).ConclusionsAmong insurance beneficiaries with prediabetes, those with NAFLD had a significantly higher risk of DM than those without NAFLD. The FLI might be useful for detecting individuals who have an especially higher risk for DM, and developing more effective guidance for delivering healthcare services in Japan.

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“…Previous studies have shown that people with NAFLD are more than twice likely to have T2DM [7], and even moderate elevation in alanine aminotransferase (ALT) levels, a poor surrogate of fatty liver, was found to be associated with high-normal glucose levels [8]. Moreover, prospective studies suggest that people with NAFLD are more likely to have T2DM at all time points of follow-up [9], [10], [11], [12], [13]. Therefore, the available evidence suggests that the deposition of fat in the liver might play a role in the development of T2DM.…”

Section: Introductionmentioning

confidence: 99%

Liver Fat Content, Evaluated through Semi-Quantitative Ultrasound Measurement, Is Associated with Impaired Glucose Profiles: A Community-Based Study in Chinese

Xia

et al. 2013

PLoS ONE

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Nonalcoholic fatty liver disease (NAFLD) is closely associated with type 2 diabetes mellitus. We investigated whether the deposition of fat in the liver is associated with glycemic abnormalities and evaluated the contribution of the liver fat content (LFC) to the impaired glucose regulation. We conducted a community-based study among 2836 residents (1018 males and 1818 females) without prior known diabetes mellitus from the Changfeng Study who were at least 45 years old. A standard interview, anthropometrics and laboratory parameters were performed for each participant. The standardised ultrasound hepatic-renal echo-intensity and hepatic echo-intensity attenuation rate were used to assess the LFC. The cohort was stratified according to the quintiles for LFC. Two-hour glucose and fasting blood glucose increased across the LFC quintiles after adjustment for age and gender. LFC increased continuously among glucose categories after adjustment for age and gender (NGT: 7.7±0.3%, IFG: 10.0±0.8%, IGT: 11.8±0.5%, IFG+IGT: 11.7±0.9%, new- DM: 12.4±0.6%, P<0.001). By logistic regression analysis, 1% LFC increment independently predicted prediabetes and diabetes (OR 1.032, 1.019–1.045, P<0.001; 1.021, 1.005–1.037, P = 0.012, respectively) after adjustment for all potential confounders. Furthermore, participants with LFC higher than 10% had higher odds ratios of impaired glucose regulation as compared with those with LFC below 10% in fully adjusted logistic models. These results suggest that the LFC is strongly associated with impaired glucose regulation in the Chinese population, and that an even slightly elevated LFC is associated with increased glucose dysregulation.

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Assessment of the fatty liver index as an indicator of hepatic steatosis for predicting incident diabetes independently of insulin resistance in a Korean population

Cited by 36 publications

References 30 publications

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Evaluation of the fatty liver index as a predictor for the development of diabetes among insurance beneficiaries with prediabetes

Liver Fat Content, Evaluated through Semi-Quantitative Ultrasound Measurement, Is Associated with Impaired Glucose Profiles: A Community-Based Study in Chinese

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