Non-alcoholic Fatty Liver Disease Is a Risk Factor for Type 2 Diabetes in Middle-aged Japanese Men and Women

Abstract

Objective Emerging studies have focused on the association between non-alcoholic fatty liver disease (NAFLD) and the risk of type 2 diabetes mellitus (T2DM). We aimed to investigate whether NAFLD diagnosed by ultrasonography could predict the risk of future T2DM in a Japanese middle-aged health check population.Methods We conducted a 10-year observational study in a health checkup population of middle-aged Japanese men and women at Hidaka Hospital from 2004 to 2013. We excluded cases with an alcohol intake exceeding 20 g/day and those with impaired glucose tolerance. The remaining 1,544 men and 864 women were classified into fatty liver and non-fatty liver groups based on the findings of abdominal ultrasonography. Both groups were followed for the development of diabetes. A multiple regression analysis was performed for each variable to predict the risk of future diabetes.Results The median age of the participants was 46.0 years at the entry, and the follow-up period was 10 years. The incidence of diabetes in the fatty liver group was 12.5% (29/232) in men and 26.3% (10/38) in women, whereas the incidence of diabetes in the non-fatty liver group was 2.5% (34/1,312) in men and 1.8% (15/826) in women. The relative risk of diabetes associated with fatty liver was 4.8 [95% confidence interval (CI) 3.0 -7.8, p<0.0001] in men and 14.5 (95% CI 7.0-30.1, p<0.0001) in women.Conclusion NAFLD was a significant predictor for future diabetes in a Japanese middle-aged health check population, especially in women.

Impact of fatty liver disease and metabolic syndrome on incident type 2 diabetes; a population based cohort study

“…In addition, we previously reported that non-overweight with NAFLD has higher risk of incident diabetes than overweight/obesity without NAFLD [24]. Moreover, recent studies revealed that metabolic syndrome individuals with NAFLD have higher risk of incident diabetes than those without NAFLD [25,26]. These studies showed that NAFLD would be a major risk factor for incident type 2 diabetes than overweight/obesity.…”

Lactobacillus sakei Alleviates High‐Fat‐Diet‐Induced Obesity and Anxiety in Mice by Inducing AMPK Activation and SIRT1 Expression and Inhibiting Gut Microbiota‐Mediated NF‐κB Activation

“…Obesity increases the risk of heart disease, type 2 diabetes, high blood pressure, and nonalcoholic fatty liver diseases . Obesity‐inducible HFD increases fat‐favorable Firmicutes and Proteobacteria populations and reduces the Bacteriodetes population in the gut microbiota of humans and mice .…”

Prevalence and severity of non‐alcoholic fatty liver disease are underestimated in clinical practice: impact of a dedicated screening approach at a large university teaching hospital

“…The association between NAFLD and Type 2 diabetes is strong; an individual's risk of developing diabetes increases up to fivefold if they have a diagnosis of NAFLD . Currently, we are unable to predict which individuals with NAFLD will subsequently develop diabetes; therefore, joint European hepatology, diabetes and obesity guidelines advocate regular screening for diabetes in those with NAFLD using HbA 1c or oral glucose tolerance testing .…”