Utility of Fatty Liver Index to predict reversion to normoglycemia in people with prediabetes

Abstract

Background Fatty Liver Index (FLI) is strongly associated with changes in glycemic status and incident Type 2 Diabetes (T2D). The probability of reverting to normoglycemia from a state prediabetes could be determined by FLI, however such relationship remains poorly understood. Aim To determine the clinical interest of using FLI to estimate prediabetes reversion at 5 years in patients with impaired fasting plasma glucose at baseline, and identify those factors associated with changes in FLI, that could contribute to the reversion of prediabetes. Methods This 5-year cohort study included 16,648 Spanish working adults with prediabetes. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dl according to the ADA criteria, while prediabetes reversion was defined as a FPG <100 mg/dL. The population was classified as: FLI <30 (no hepatic steatosis), FLI 30–59 (intermediate status), and FLI ≥60 (hepatic steatosis). Results At 5 years follow-up, 33.7% of subjects reverted to normoglycemia (annual rate of 6.7%). The adjusted binomial logistic regression model showed that scoring FLI <30 (OR 1.544; 95% CI 1.355–1.759), performing at least 150 min/week of physical activity (OR 4.600; 95% CI 4.088–5.177) and consuming fruits and vegetables daily (OR 1.682; 95% CI 1.526–1.855) were associated with the probability of reverting form prediabetes to normoglycemia. The ROC curve for prediction of reversion showed that FLI (AUC 0.774;95% CI 0.767–0.781) was a better predictor than FPG (AUC 0.656; 95% CI 0.648–0.664). Conclusions Regular physical activity, healthy dietary habits and absence of hepatic steatosis are independently associated with the probability of reversion to normoglycemia in adult workers with prediabetes at baseline. Low FLI values (especially FLI< 30) may be useful to predict the probability of prediabetes reversion, especially in active subjects with healthy eating habits, and thus identify those who might benefit from early lifestyle intervention.

Fatty liver index and progression to type 2 diabetes: a 5-year longitudinal study in Spanish workers with pre-diabetes

“…The study also reported that FLI could predict the risk of progressing to T2D as well as the possibility of reverting to normoglycaemia in clinical practice, independently of classical glucose parameters. 46 Moreover, normalisation of glycaemia was higher in subjects with FLI<30 than in those with higher FLI scores. The incidence of T2D observed in our study was higher than in previous ones [47][48][49] probably due to differences in sociodemographic characteristics between study populations.…”

Hepatic Steatosis Index and the Risk of Type 2 Diabetes Mellitus in China: Insights from a General Population-Based Cohort Study

“…Likewise, similar conclusions were reached in an open-label, cluster-randomized trial (DiRECT) [ 40 ]. In a 5-year observational cohort study, Busquets-Cortés et al [ 41 ] included a total of 16,648 adults with prediabetes. This study further demonstrated that regular physical activity and a healthy diet can help reverse prediabetes by improving the degree of hepatic steatosis.…”

Effect of Vitamin D Supplementation on Glycemic Control in Prediabetes: A Meta-Analysis

“…The reason for this was not only the difference in dosage; the progression of diabetes could also weaken the effect of long-term intervention over time. Prediabetes is a reversible process, but T2DM is not [52]. Therefore, the longer the vitamin D supplementation in prediabetes, the more effective the prevention of the onset of diabetes and the less likely the disease will progress.…”