Nonalcoholic fatty liver disease in relation to the remission and progression along the glycemic continuum.

Abstract

BACKGROUND:

The study aimed to explore the associations of nonalcoholic fatty liver disease (NAFLD) with the remission and progression along the glycemic continuum.

METHODS:

This prospective cohort study was performed among the general population in 2010-2015. NAFLD was defined as ultrasound-detected hepatic steatosis with absence of excessive alcohol consumption and other hepatic diseases. Remission of type 2 diabetes referred to glycated hemoglobin <6.5% without hypoglycemic agents for ≥3 months. Prediabetes remission referred to normalization of blood glucose. Multivariable logistic analysis was applied to identify the risk of glycemic metabolic transition.

RESULTS:

During a median follow-up of 4.3 years, participants with NAFLD had a significantly higher risk of progressing from normal glucose tolerance to diabetes (3.36 [1.60-7.07]) and lower likelihood of diabetes remission (0.48 [0.30-0.78]). Associations in participants with overweight or obesity and higher probability of hepatic fibrosis remained consistent. Results related to the effect of NAFLD on the specific glucose parameters were generally in line with the changes of glycemic status. NAFLD improvement decreased the risk of prediabetes progressing to diabetes (0.50 [0.32-0.80]) and increased the probability of prediabetes remission (2.67 [1.49-4.79]). NAFLD tended to show the most significant association with glycemic progression and decreased the likelihood in remission of prediabetes and diabetes.

CONCLUSIONS:

Presence of NAFLD increased risk of glycemic progression and decreased likelihood of remission. NAFLD improvement mitigated glycemic deterioration, whereas NAFLD progression impeded the chance of remission. The results emphasized joint management of NAFLD and diabetes and further focused on liver-specific subgroups of diabetes to tailor early intervention.

• Authors: Zhuojun Xin, Jiaojiao Huang, Qiuyu Cao, Jialu Wang, Ruixin He, Tianzhichao Hou, Yi Ding, Jieli Lu, Min Xu, Tiange Wang, Zhiyun Zhao, Weiqing Wang, Guang Ning, Yufang Bi, Yu Xu, Mian Li
• Journal: Journal of diabetes (J Diabetes) Vol. 14 Issue 9 Pg. 606-619 (Sep 2022) ISSN: 1753-0407 [Electronic] Australia
• PMID: 36163589 (Publication Type: Journal Article)
• Copyright: © 2022 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Hypoglycemic Agents

Topics

• Blood Glucose
• Diabetes Mellitus, Type 2
• Glycated Hemoglobin
• Humans
• Hypoglycemic Agents
• Non-alcoholic Fatty Liver Disease (epidemiology)
• Prediabetic State (epidemiology)
• Prospective Studies
• Risk Factors