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

Abstract

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.

I148M variant of PNPLA3 increases the susceptibility to non‐alcoholic fatty liver disease caused by obesity and metabolic disorders

“…The liver fat content determined by the quantitative ultrasound method showed an excellent correlation and consistency with that obtained by proton magnetic resonance ( r = 0.89, P < 0.001), and a good correlation with the histology‐determined steatosis grade ( r = 0.79, P < 0.001) . It has previously been evaluated and used for large‐scale population studies …”

“…In our previous study, we established a method for the computer‐aided ultrasound measurement of LFC based on the ultrasound hepatic/renal ratio and hepatic attenuation rate using a traditional ultrasonic apparatus, and the accuracy of the quantitative ultrasound examination was established using [ 1 H]‐MRS as a reference and was consistent with both [ 1 H]‐MRS ( r = 0.89, P < 0.001) and the histology‐determined steatosis grade ( r = 0.79, P < 0.001) . The method has also previously been evaluated and used for large‐scale population studies . Therefore, we can quantitatively analyse the associations of the liver fat content by quantitative ultrasonography and metabolic parameters.…”

“…24 It has previously been evaluated and used for large-scale population studies. [24][25][26] Carotid artery ultrasonography The carotid arteries were evaluated using the same machine with a 10-MHz probe. The carotid intimamedia thickness (CIMT) on both sides was measured at the common carotid artery approximately 1 cm proximal to the bifurcation at the far wall during end diastole.…”

Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content

“…In this study, the hepatic/renal ratio and hepatic echo-intensity attenuation rate were highly correlated with 1 H-MRS liver fat content; suggesting that these methods could also accurately assess liver fatty content as well. Compared with 1 H-MRS, these methods are more convenient, economic, and easy to operate [3,12,13] , which can be used as new tools for clinical NAFLD diagnosis.…”

“…NAFLD was also reported to be associated with increased insulin resistance [2] . A meta-analysis showed that the prevalence of diabetes significantly increased in patients with NAFLD, and was 2-3 times higher than normal [3] . If the disease is not diagnosed early, abnormal glucose metabolism and cardiovascular disease could easily manifest in patients with NAFLD.…”