Hepatic Steatosis and High-Normal Fasting Glucose as Risk Factors for Incident Prediabetes

Abstract

Objective To clarify the impact of hepatic steatosis (HS) indexed by Fatty Liver Index (FLI) and high normal fasting plasma glucose (FPG) as risk factors for incident prediabetes in a non-obese cohort. Methods Data from 1,125 participants with ADA-defined normal glucose metabolism (NGM) (median age and BMI, 52 years and 23.1 kg/m 2, respectively) were used for retrospective analysis. In the entire population, correlation between normal FPG and FLI was evaluated by multiple regression with adjustment for age and sex. Follow-up data from 599 participants in whom 75 g OGTT was repeated 3.7 years later showed that 169 developed prediabetes. This was analyzed by the multivariate Cox proportional hazards model. Results In the entire population, FLI was positively correlated with FPG (P <0.01): mean FLI increased from 15.8 at FPG 4.2 mmol/L to 31.6 at FPG 5.5 mmol/L. Analysis of the 599 participants (2,061 person-years) by Cox model, adjusted for sex, age, family history of diabetes, ISIMATSUDA and Stumvoll-1, clarified an increased risk of prediabetes with high normal FPG and FLI. In in participants with FLI≥16.5, as compared with FLI <16.5, P<0.001. The risk was also increased (2.1 times) in participants with FPG ≥5.3 mmol/L, P<0.001. The cutoff values (unadjusted) were obtained by ROC at the point of the largest Youden’s index using the entire range of the variables. Conclusions Even among non-obese individuals, HS indexed by FLI and a high-normal FPG (≥5.3 mmol/L) are risk factors for prediabetes, independently from insulin.

Body Roundness Index Is Better Correlated with Insulin Sensitivity than Body Shape Index in Young and Middle-Aged Japanese Persons

“… 21 Serum IRI concentrations were determined using a chemiluminescence immunoassay (Siemens Healthcare Diagnostics, Tokyo, Japan) at a commercial laboratory (BML, Inc., Tokyo, Japan) (Hokuriku cohort). 19 , 20 The antibodies used in both insulin assays did not cross-react with proinsulin. In the 75-g OGTT, PG and IRI levels were measured under fasting conditions (preloading) and 120 min after glucose loading; these are abbreviated as PG0 and PG120, and IRI0 and IRI120, respectively.…”

“…The detailed characteristics of the study population have been described elsewhere. 19 , 20 Briefly, 2153 participants who visited the hospital between April 2006 and March 2010 were enrolled in this study after excluding those who had Hemoglobin A1c values ≥6.5%, who had a known history of diabetes mellitus and/or taking antidiabetic agents, who had undergone gastrectomy, who were taking steroids, or who were taking anticancer drugs. The study was approved by the Ethics Committee of the Hokuriku Central Hospital.…”

“…The study was approved by the Ethics Committee of the Hokuriku Central Hospital. 19 , 20 Written, informed consent was obtained from all participants after providing full information on the purposes of the study (Hokuriku cohort).…”