Fatty liver index is a predictor of incident diabetes in patients with prediabetes: The PREDAPS study

Franch-Nadal, Josep; Caballería, Llorenç; Mata-Cases, Manel; Mauricio, Dı́dac; Giráldez‐García, Carolina; Mancera, José Jorge Celio; Goday, Albert; Mundet, Xavier; Regidor, Enrique

doi:10.1371/journal.pone.0198327

Cited by 39 publications

(43 citation statements)

References 75 publications

(83 reference statements)

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“…Our results show that individuals with isolated impaired HbA1c when diagnosed with pre-diabetes might have a slightly better cardiometabolic risk profile than those with isolated FPG, while those individuals with both impaired FPG and HbA1c had the worst cardiovascular risk. These results are in line with the findings of the prospective observational study in the primary care setting of a Spanish cohort with pre-diabetes (PREDAPS) of our group 35 36…”

Section: Discussionsupporting

confidence: 90%

Prevalence of pre-diabetes and undiagnosed diabetes in the Mollerussa prospective observational cohort study in a semi-rural area of Catalonia

Falguera

Vilanova

Alcubierre³

et al. 2020

BMJ Open

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ObjectivesTo assess the prevalence of undiagnosed diabetes and pre-diabetes in the healthy population in the Mollerussa cohort. As a secondary objective, to identify the variables associated with these conditions and to describe the changes in glycaemic status after 1 year of follow-up in subjects with pre-diabetes.DesignProspective observational cohort study.SettingGeneral population from a semi-rural area.ParticipantsThe study included 583 participants without a diagnosis of diabetes recruited between March 2011 and July 2014.ResultsThe prevalence of undiagnosed diabetes was 20, 3.4% (95% CI 2.6 to 4.2) and that of pre-diabetes was 229, 39.3% (37.3 to 41.3). Among those with pre-diabetes, 18.3% had isolated impaired fasting plasma glucose (FPG) (FPG: 100 to <126 mg/dL), 58.1% had isolated impaired glycated haemoglobin (HbA1c) (HbA1c 5.7 to <6.5) and 23.6% fulfilled both criteria. Follow-up data were available for 166 subjects; 41.6%(37.8 to 45.4) returned to normoglycaemia, 57.6% (57.8 to 61.4) persisted in pre-diabetes and 0.6% (0 to 1.2) progressed to diabetes. Individuals with pre-diabetes had worse cardiometabolic risk profiles and sociodemographic features than normoglycaemic subjects. In the logistic regression model, variables significantly associated with pre-diabetes were older age (OR; 95% CI) (1.033; 1.011 to 1.056), higher physical activity (0.546; 0.360 to 0.827), body mass index (1.121; 1.029 to 1.222) and a family history of diabetes (1.543; 1.025 to 2.323). The variables significantly associated with glycaemic normalisation were older age (0.948; 0.916 to 0.982) and body mass index (0.779; 0.651 to 0.931).ConclusionsAmong adults in our region, the estimated prevalence of undiagnosed diabetes was 3.4% and that of pre-diabetes was 39.3%. After a 1-year follow-up, a small proportion of subjects (0.6%) with pre-diabetes progressed to diabetes, while a high proportion (41.6%) returned to normoglycaemia. Individuals with pre-diabetes who returned to normoglycaemia were younger and had a lower body mass index.

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Section: Discussionsupporting

confidence: 90%

Prevalence of pre-diabetes and undiagnosed diabetes in the Mollerussa prospective observational cohort study in a semi-rural area of Catalonia

Falguera

Vilanova

Alcubierre³

et al. 2020

BMJ Open

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“…Diabetes mellitus also has significant association with NAFLD 35 . Furthermore, a recent article has revealed that FLI is a predictor of diabetes mellitus in a longitudinal study 36 . In concordance, our data showed a stronger association between FLI and periodontitis prevalence in the subgroup with diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

Association between Fatty Liver Index and Periodontitis: the Korea National Health and Nutrition Examination Survey

Kim

Lee

Song

et al. 2020

Sci Rep

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it has been suggested that periodontitis is associated with metabolic abnormalities including nonalcoholic fatty liver disease (nAfLD). the fatty liver index (fLi) is a non-invasive surrogate marker and predictor of nAfLD. We aimed to determine whether fLi itself would be associated with periodontitis through a secondary analysis of previously reported nationally representative probability sample data of the Korean population. fLi was calculated from a previously developed algorithm which combines measures of body mass index (BMi), waist circumference, triglyceride, and gamma-glutamyl transferase (GGt). periodontitis was diagnosed based on the community periodontal index (cpi) developed by the World Health Organization. Of 4,272 participants, 26.1% were diagnosed with periodontitis. Higher fLi was associated with a higher prevalence of periodontitis (odds ratio (oR) highest vs. lowest quartile of fLi ,1.63; 95% confidence interval (CI), 1.23-2.16; P = 0.001 for trend) adjusting for confounding factors. in the highest fLi quartile, prevalence of periodontitis was higher in individuals with diabetes (oR highest vs. lowest quartile of fLi , 2.89; 95% CI, 1.01-8.27 for diabetic subgroup; OR highest vs. lowest quartile of fLi , 1.45; 95% CI, 1.07-1.96 for non-diabetic subgroup). In summary, FLI was associated with prevalent periodontitis. Periodontitis is a dental bacteria-induced chronic inflammatory condition characterized by immunologic destruction of supporting structures of teeth 1. Approximately half of the adult U.S. population suffers from periodontitis with data from the 2009 and 2010 National Health and Nutrition Examination Survey 2. Associations between periodontitis and other health problems including obesity, coronary heart disease, stroke, metabolic syndrome, diabetes mellitus, and non-alcoholic fatty liver disease (NAFLD) have been already discovered 3-8. Fatty liver index (FLI) is an algorithm that combines measures of body mass index (BMI), waist circumference, triglyceride, and gamma-glutamyl transferase (GGT) 9. FLI is a non-invasive surrogate marker and predictor of NAFLD 8,9. For the definitive diagnosis of NAFLD, the ultrasonic evaluation or liver biopsy is required, while FLI may allow us to identify NAFLD in large-scale epidemiological research. We hypothesize that FLI may be associated with periodontitis prevalence. Therefore, the objective of this study was to assess the relationship between FLI and periodontitis in a large probability sample of the Korean population using data from the 2010 Korea National Health and Nutrition Examination Survey (KNHANES). Since NAFLD accounts for 20-30% and 5-18% of the general population in Western and Asian countries 10 , respectively, it is assumable that a population group with a high prevalence of periodontitis may exist among those not diagnosed with NAFLD but possess high FLI. This hypothesis may be observable in a large population dataset such as KNHANES. Benefitting from the size of the dataset, we stratified the Korean general population according...

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“…In addition to IFG and IGT, the status of NAFLD associated with the newly categorized isolated high HbA1c group, which might have been categorized into the normal glycemic population in the past, had not been previously understood. Nevertheless, the prevalence of prediabetes with NAFLD has been estimated to range from 44 to 62% in the USA, from 45 to 78% in Germany and 60% in Korea, which suggests a future epidemic of liver complications 17 and the development of diabetes 18 . The disappearance of fatty liver could also be a prognostic factor for regression from IGT to normal glucose regulation in individuals with NAFLD 19 .…”

Section: Introductionmentioning

confidence: 99%

Increased risks of different grades of non‐alcoholic fatty liver disease in prediabetic subjects with impaired fasting glucose and glucose tolerance, including the isolated glycosylated hemoglobin levels of 5.7–6.4% in a Chinese population

Chou

Shen

et al. 2020

J of Diabetes Invest

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Aims/Introduction Contrary to the results of the majority of studies on diabetes, there are some conflicting results regarding the relationship between non‐alcoholic fatty liver disease (NAFLD) and prediabetes. No study has investigated the relationship between isolated glycated hemoglobin (HbA1c) in the range of 5.7–6.4% (HbA1c 5.7–6.4%) and NAFLD. Our aim was to investigate the effect of different glycemic statuses on NAFLD concomitantly categorized by fasting plasma glucose, 2‐h plasma glucose and HbA1c levels. Materials and Methods NAFLD was classified into three groups by ultrasonographic examination results: normal, mild and moderate‐to‐severe. Glycemic status was divided into five groups: normoglycemia, isolated HbA1c 5.7–6.4%, impaired fasting glucose without impaired glucose tolerance (IGT), IGT and newly diagnosed diabetes. For multivariable logistic regression analyses, the outcome variable was the classified three grades of fatty changes in the liver after adjusting for other potential risk covariables. Results In this cross‐sectional research, a total of 8,571 eligible individuals were enrolled and divided into three groups: 5,499 without fatty liver, 2,113 with mild NAFLD and 959 with moderate‐to‐severe NAFLD. Multivariable logistic regression analysis showed that IGT, impaired fasting glucose without IGT and isolated HbA1c 5.7–6.4% were associated with a higher risk of NAFLD in addition to newly diagnosed diabetes. Other positively predictive variables were male sex, obesity, overweight, central obesity, increased triglyceride and C‐reactive protein >1 mg/L. Negatively associated factors were elevated high‐density lipoprotein cholesterol levels. Conclusions Besides diabetes, the increased risks of different grades of NAFLD were found for prediabetic individuals categorized by impaired fasting glucose without IGT, IGT and isolated HbA1c 5.7–6.4%.

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Fatty liver index is a predictor of incident diabetes in patients with prediabetes: The PREDAPS study

Cited by 39 publications

References 75 publications

Prevalence of pre-diabetes and undiagnosed diabetes in the Mollerussa prospective observational cohort study in a semi-rural area of Catalonia

Prevalence of pre-diabetes and undiagnosed diabetes in the Mollerussa prospective observational cohort study in a semi-rural area of Catalonia

Association between Fatty Liver Index and Periodontitis: the Korea National Health and Nutrition Examination Survey

Increased risks of different grades of non‐alcoholic fatty liver disease in prediabetic subjects with impaired fasting glucose and glucose tolerance, including the isolated glycosylated hemoglobin levels of 5.7–6.4% in a Chinese population

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