Postprandial glucose is correlated with an increasing risk of liver fibrosis in Chinese patients with nonalcoholic fatty liver disease - 18/07/22

Doi : 10.1016/j.diabet.2022.101377

Xinxia Chang ^1,^2,^{^{#
These authors contributed equally.}}, Hua Bian ^1,^2,^{^{#
These authors contributed equally.}}, Mingfeng Xia ^1,², Xiaopeng Zhu ^1,², Xiaoyang Sun ^1,², Xinyu Yang ^1,², Jian Gao ^3,^4,^⁎ , Huandong Lin ^1,^2,^⁎ , Hongmei Yan ^1,^2,^⁎ , Xin Gao ^1,²
¹ Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
² Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China
³ Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai 200032, China
⁴ Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

^⁎Address of correspondence: Dr Hongmei Yan, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China.Department of Endocrinology and MetabolismZhongshan Hospital, Fudan University, Shanghai, 200032, China. Fudan Institute for Metabolic Diseases, Fudan UniversityShanghai200032China^⁎⁎Co-correspondence: Prof. Huandong Lin, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, ChinaDepartment of Endocrinology and MetabolismZhongshan Hospital, Fudan University, Shanghai, 200032, China. Fudan Institute for Metabolic Diseases, Fudan UniversityShanghai200032China^⁎⁎⁎Co-correspondence: Dr Gao Jian, Center of Clinical Epidemiology and Evidence-based Medicine of Fudan University, Shanghai 200032, China; Department of clinical nutrition, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.Center of Clinical Epidemiology and Evidence-based Medicine of Fudan University, Shanghai 200032, China; Department of clinical nutrition, Zhongshan Hospital, Fudan UniversityShanghai200032China

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Abstract

Aim

Type 2 diabetes (T2DM) is closely related to nonalcoholic fatty liver disease (NAFLD) and is an important risk factor for the progression of liver fibrosis, but the role of 2-h postprandial blood glucose (PPG) as a biomarker in this process remains unclear. This study was designed to investigate the relationship between PPG and liver fibrosis in Chinese NAFLD populations with or without T2DM.

Methods

This study included three independent NAFLD populations:1) 618 inpatients with T2DM or pre-diabetes, 2) 255 patients with T2DM or pre-diabetes who underwent liver biopsy, and 3) a prospective community-based cohort without diabetes who completed a median of 4.22 years follow-up. The degree of liver fibrosis was assessed by liver fibrosis stage in subjects with a liver biopsy, and by NAFLD fibrosis score (NFS) in subjects without liver biopsy.

Results

In the first population, PPG {OR 0.02, [95% CI (0.01-0.03)], P< 0.0001} was positively correlated with NFS. In the second population, an increasing PPG was associated with increase in the proportion of advanced liver fibrosis (P = 0.012). Multivariate line regression revealed that PPG {OR 0.03 [95% CI (0.00-0.06)], P = 0.049}was positively associated with liver fibrosis stages. In the third population, PPG {OR 0.103, [95% CI (0.011-0.194) P = 0.028} at baseline was positively associated with NFS at follow-up. Furthermore, changes in PPG were significantly associated with NFS change after follow-up. We did not find a similar association between fasting glucose or HbA1c and liver fibrosis.