A1 Refereed original research article in a scientific journal
Fatty liver index predicts incident risk of prediabetes, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD)
Authors: Cuthbertson Daniel J., Koskinen Juha, Brown Emily ,Magnussen Costan G. Hutri-Kähönen Nina,Sabin Matthew, Tossavainen Päivi , Jokinen Eero, Laitinen Tomi, Viikari Jorma, Raitakari Olli T, Juonala Markus
Publisher: TAYLOR & FRANCIS LTD
Publication year: 2021
Journal: Annals of Medicine
Journal name in source: ANNALS OF MEDICINE
Journal acronym: ANN MED
Volume: 53
Issue: 1
First page : 1256
Last page: 1264
Number of pages: 9
ISSN: 0785-3890
eISSN: 1365-2060
DOI: https://doi.org/10.1080/07853890.2021.1956685
Web address : https://doi.org/10.1080/07853890.2021.1956685
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/66914192
Aims To investigate the association between overweight/obesity and fatty liver index (FLI) on the odds of incident prediabetes/type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) in 2020 participants after 10 years follow up. Methods At baseline (in 2001) 2020 participants, males and females, aged 24-39 years, were stratified according to body mass index (BMI), normal weight (<25 kg/m(2)), overweight (>= 25-<30 kg/m(2)), or obese (>= 30 kg/m(2)) and FLI (as high FLI >= 60 or low FLI <60). We examined the incidence of prediabetes/type 2 diabetes and NAFLD (ultrasound assessed) over 10 years to 2011 to determine the relative impact of FLI and BMI. Results 514 and 52 individuals developed prediabetes and type 2 diabetes during follow-up. Such individuals were older, with higher BMI, serum glucose, insulin, alanine aminotransferase (ALT) and triglyceride (TG) concentrations than those who did not develop prediabetes or type 2 diabetes (n = 1454). The additional presence of high FLI significantly increased the risk of developing prediabetes and type 2 diabetes above the risk of being overweight/obese. Compared with normal weight, low FLI participants, the odds of prediabetes were similar to 2-fold higher and the odds of type 2 diabetes were 9-10-fold higher respectively in the overweight/obese, high FLI group. No difference was observed between normal weight, low FLI and overweight/obese and low FLI groups. Conclusions An increased FLI significantly increases the odds of incident prediabetes, type 2 diabetes and NAFLD in individuals with overweight/obese highlighting the contributory role of liver fat accumulation in the pathophysiology of prediabetes/type 2 diabetes. Key messages Obesity is a risk factor for non-alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes. Additionally, NAFLD is more prevalent in people with prediabetes and type 2 diabetes when compared to age- and BMI-matched individuals. The presence of a raised fatty liver index (FLI) confers a significantly increased risk of developing prediabetes, type 2 diabetes and NAFLD above that conferred by being overweight/obese. The degree of elevation of FLI can risk stratify for incident prediabetes and type 2 diabetes in people with obesity.
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