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Lean non-alcoholic fatty liver disease and risk of incident diabetes in a euglycaemic population undergoing health check-ups: A cohort study - 17/10/20

Doi : 10.1016/j.diabet.2020.08.008 
Limin Wei a, 1, Xin Cheng b, 1, Yulong Luo a, Rongxuan Yang a, Zitong Lei a, Hongli Jiang a, , Lei Chen a,
a Dialysis Department of Nephrology Hospital, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China 
b Nephrology Department of Eastern Hospital, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China 

Corresponding author at: Dialysis Department of Nephrology Hospital, The First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, Shaanxi 710061, China.Dialysis Department of Nephrology HospitalThe First Affiliated Hospital of Xi’an Jiaotong University277 West Yanta RoadXi’anShaanxi710061China
Sous presse. Manuscrit accepté. Disponible en ligne depuis le Saturday 17 October 2020

Abstract

Introduction

Convincing evidence suggests that non-alcoholic fatty liver disease (NAFLD) is associated with insulin resistance and an increased risk of diabetes; however, the association between lean NAFLD and incident diabetes, and especially differences according to gender, have not been reported thus far. This study therefore aimed to investigate whether lean NAFLD and overweight/obese NAFLD confer the same excess risk of new-onset diabetes in both genders.

Methods

Our longitudinal study was performed in 14,482 euglycaemic adults who had participated in a health checkup programme. Fatty liver was diagnosed by abdominal ultrasonography. The outcome of interest was incident diabetes.

Results

Over the median 6.0 years of follow-up, 356 cases of diabetes were diagnosed. After adjusting for sociodemographic and other potential confounders, the fully adjusted HR (95% CI) for incident diabetes in lean NAFLD vs lean without NAFLD patients was 2.58 (95% CI: 1.68–3.97) in the total cohort. Corresponding HRs were 5.53 (95% CI: 2.30–13.30) and 2.02 (95% CI: 1.24–3.31) for women and men, respectively. Post-hoc analysis revealed that the relative risk for developing diabetes was similar between lean and overweight/obese NAFLD groups whether in the entire study population or in subgroups stratified by gender (all P> 0.05).

Conclusion

Lean NAFLD is indeed a risk factor for incident type 2 diabetes in both genders, although the effect appeared to be more pronounced in women than in men. Further investigations are now needed to obtain a better understanding of the natural history of NAFLD in lean subjects.

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Abbreviations : NAFLD, T2DM, BMI, WC, IFG, FPG, AST, ALT, TC, TG, HDL-c

Keywords : Lean non-alcoholic fatty liver disease, Obesity, Gender differences, Type 2 diabetes



© 2020  Publié par Elsevier Masson SAS.
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