TY - JOUR
T1 - Nonalcoholic fatty liver disease and risk of diabetes
T2 - A prospective study in China
AU - Shen, Xiuhua
AU - Cai, Jianfang
AU - Gao, Jingsheng
AU - Vaidya, Anand
AU - Liu, Xuemei
AU - Li, Wen
AU - Chen, Shuohua
AU - Zhou, Yong
AU - Li, Yinge
AU - Zhang, Yanmin
AU - Zhao, Jianqiu
AU - Hu, Frank B.
AU - Wu, Shouling
AU - Gao, Xiang
N1 - Publisher Copyright:
© 2018 AACE.
PY - 2018/9
Y1 - 2018/9
N2 - Objective: We aimed to investigate whether liver steatosis severity affects the risk of developing diabetes in a large cohort study. Methods: We prospectively examined the association in 41,650 Chinese adults with negative hepatitis-B surface antigen who were free of alcohol consumption, diabetes, and liver cirrhosis at baseline. Cox proportional models were used to estimate the risk of diabetes after a mean of 3.6 years of follow-up. Nonalcoholic fatty liver disease (NAFLD) was assessed with hepatic ultrasonography. Elevated alanine transaminase (ALT) was defined as ALT concentrations >19 and >30 U/L in females and males, respectively. Diabetes was defined as a fasting glucose 7.0 mmol/L or treatment with hypoglycemic medication. Results: Liver steatosis severity was significantly associated with higher risks of developing diabetes (adjusted hazard ratio [HR] for severe vs. without NAFLD = 2.66, 95% confidence interval [CI]: 2.17-3.25, P-trend<.001) and impaired fasting glucose (fasting glucose between 5.6 and 6.9 mmol/L, adjusted HR = 1.36, 95% CI: 1.16-1.59, P-trend<.001), as well as a faster increase rate of fasting glucose concentrations (P-trend<.001), during 3.6 years of follow-up. Elevated ALT was also associated with incident diabetes (HR = 1.12, 95% CI: 1.02-1.22), adjusting for NAFLD and other covariates. Conclusion: We observed a dose-response relationship between liver steatosis severity and increased diabetes risk, and ALT may predict incident diabetes independently of NAFLD. (Endocr Pract.
AB - Objective: We aimed to investigate whether liver steatosis severity affects the risk of developing diabetes in a large cohort study. Methods: We prospectively examined the association in 41,650 Chinese adults with negative hepatitis-B surface antigen who were free of alcohol consumption, diabetes, and liver cirrhosis at baseline. Cox proportional models were used to estimate the risk of diabetes after a mean of 3.6 years of follow-up. Nonalcoholic fatty liver disease (NAFLD) was assessed with hepatic ultrasonography. Elevated alanine transaminase (ALT) was defined as ALT concentrations >19 and >30 U/L in females and males, respectively. Diabetes was defined as a fasting glucose 7.0 mmol/L or treatment with hypoglycemic medication. Results: Liver steatosis severity was significantly associated with higher risks of developing diabetes (adjusted hazard ratio [HR] for severe vs. without NAFLD = 2.66, 95% confidence interval [CI]: 2.17-3.25, P-trend<.001) and impaired fasting glucose (fasting glucose between 5.6 and 6.9 mmol/L, adjusted HR = 1.36, 95% CI: 1.16-1.59, P-trend<.001), as well as a faster increase rate of fasting glucose concentrations (P-trend<.001), during 3.6 years of follow-up. Elevated ALT was also associated with incident diabetes (HR = 1.12, 95% CI: 1.02-1.22), adjusting for NAFLD and other covariates. Conclusion: We observed a dose-response relationship between liver steatosis severity and increased diabetes risk, and ALT may predict incident diabetes independently of NAFLD. (Endocr Pract.
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U2 - 10.4158/EP-2018-0098
DO - 10.4158/EP-2018-0098
M3 - Article
C2 - 29975579
AN - SCOPUS:85054728733
SN - 1530-891X
VL - 24
SP - 823
EP - 832
JO - Endocrine Practice
JF - Endocrine Practice
IS - 9
ER -