Hepatic Steatosis Index and the Risk of Type 2 Diabetes Mellitus in China: Insights from a General Population-Based Cohort Study

Abstract

Purpose. In the Chinese population, we looked at the relationship between the hepatic steatosis index (HSI) and the risk of type 2 diabetes mellitus (T2DM). Methods. To evaluate the association between HSI and the risk of T2DM, Cox regression models were employed. Hazard ratios (HR) and 95 percent confidence intervals (CI) were computed. A stratified analysis with interaction testing was also carried out. Additionally, we evaluated the incremental predictive value of the HSI over the established risk factors using the C-statistic, the IDI, and the NRI. Results. During a median follow-up period of 2.97 years, 433 (1.97%) participants developed new-onset T2DM. The smoothing curve fit plot showed a positive correlation between HSI and the risk of T2DM. After adjusting for all noncollinear variables, the risk of T2DM increased by 62% for every 1 standard deviation (SD) increase in HSI. Subgroup analysis indicated that higher HSI levels were associated with a higher risk of T2DM in those aged < 40 years. The addition of HSI enhanced the reclassification and discrimination of established risk factors, with an IDI of 0.027 and an NRI of 0.348 (both P < 0.001 ). Conclusion. Our findings suggest that an elevated HSI is substantially associated with a greater risk of T2DM in the Chinese population. HSI has the potential to be an available and supplementary monitoring method for the management of T2DM risk stratification in the Chinese population.

Linear Relationship between Hepatic Steatosis Index and Major Adverse Cardiovascular Events in Hypertensive Patients with Obstructive Sleep Apnea: A Real-World Cohort Study from China

“…Cai et al . [ 13 ] discovered that a 1-SD increase in the HSI in a healthy group was related to a 62% greater chance of developing diabetes. In addition, Han et al .…”

“…The hepatic steatosis index (HSI), which is calculated using the formula HSI = 8 (alanine aminotransferase [ALT]/aspartate aminotransferase [AST] ratio) + body mass index (BMI) (+2, if female; +2, if diabetes) was originally used to evaluate hepatic steatosis [ 12 ]. While the HSI can effectively evaluate hepatic steatosis (its sensitivity and specificity for diagnosing nonalcoholic fatty liver disease are both above 90%), it has been also shown to be related to the severity of diseases such as type 2 diabetes, CVD, and organ injuries unrelated to hypertension [ 13 , 14 , 15 , 16 ]. The aforementioned findings indicate an association between the HSI and other diseases, and suggest that this association is related to a high metabolic risk in the population.…”

Relationships between statins and risk reduction of aortic dissection in patients with hypertension

“…The imputation data were not signi cantly different from the original data (Table S1). The Rubin method was applied for statistical analysis [23].…”

“…Traditional belief is that the prevention of aortic dissection is mainly achieved through lowering of blood pressure with antihypertensive drugs. We therefore conducted sensitivity analysis after excluding those taking antihypertensive drugs [21,23] and con rmed that statins independently protect against aortic dissection.…”

Association Between the Hepatic Steatosis Index and Risk of Incident Type 2 Diabetes Mellitus in the Normoglycemic Population:A Longitudinal Prospective Study in Japan

“… 11–13 However, limited research exists on using HSI to directly predict incident T2DM, and the existing studies only include individuals with pre-diabetes, which could potentially confound the accuracy of prediction. 14 The predictive accuracy of HSI in individuals with normal blood glucose levels has not been validated yet. Therefore, this study aims to assess the association between baseline HSI and incident T2DM in normoglycemic individuals and to examine whether this association differs by sex.…”