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Fatty liver index is a risk determinant of incident type 2 diabetes in a metabolically healthy population with obesity
Author(s) -
Jung Chang Hee,
Kang Yu Mi,
Jang Jung Eun,
Hwang Jenie Yoonoo,
Kim Eun Hee,
Park JoongYeol,
Kim HongKyu,
Lee Woo Je
Publication year - 2016
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21483
Subject(s) - medicine , type 2 diabetes , fatty liver , diabetes mellitus , obesity , population , body mass index , gastroenterology , multivariate analysis , endocrinology , disease , environmental health
Objective This study investigated the effect of fatty liver disease (FLD) on the risk of incident type 2 diabetes in a population with metabolically healthy obesity (MHO). Methods The study population comprised 34,258 Koreans without type 2 diabetes. Participants were stratified by BMI (cutoff value, 25.0 kg/m 2 ) and metabolic health state (using Wildman criteria). FLD was defined by the fatty liver index (FLI), a predictive algorithm to detect FLD. Subjects were classified into low and high FLI groups based on tertile. Results At baseline, there were significant differences in FLI between four study groups. During a median follow‐up of 36.5 months, 1.7% individuals developed type 2 diabetes. The risk of incident type 2 diabetes varied for the MHO group according to the level of FLI. The risk of type 2 diabetes in the MHO with low FLI was not significantly elevated compared with the metabolically healthy individuals without obesity (MHNO) with low FLI (multivariate‐adjusted HR, 1.19 [95% CI 0.66‐2.14]). However, the MHO with high FLI had an elevated risk of incident type 2 diabetes (multivariate‐adjusted HR, 1.99 [95% CI 1.36‐2.92]). Conclusions MHO subjects have a substantially higher risk of incident type 2 diabetes than MHNO subjects. The presence of FLD assessed by FLI partially explains this increased risk.