These authors contributed equally to this work.
Steatohepatitis/Metabolic Liver Disease
Clinical availability of nonalcoholic fatty liver disease as an early predictor of type 2 diabetes mellitus in korean men: 5-year prospective cohort study†
Article first published online: 8 APR 2013
Copyright © 2012 American Association for the Study of Liver Diseases
Volume 57, Issue 4, pages 1378–1383, April 2013
How to Cite
Park, S. K., Seo, M. H., Shin, H. C. and Ryoo, J.-H. (2013), Clinical availability of nonalcoholic fatty liver disease as an early predictor of type 2 diabetes mellitus in korean men: 5-year prospective cohort study. Hepatology, 57: 1378–1383. doi: 10.1002/hep.26183
Potential conflict of interest: Nothing to report.
- Issue published online: 8 APR 2013
- Article first published online: 8 APR 2013
- Accepted manuscript online: 5 DEC 2012 02:51AM EST
- Manuscript Accepted: 24 OCT 2012
- Manuscript Received: 22 AUG 2012
There have been several reports about the clinical association between type 2 diabetes mellitus (DM) and nonalcoholic fatty liver disease (NAFLD). However, most of the studies were about the unilateral effects of type 2 DM on NAFLD, and studies on the reverse relation are rare. Thus, this study was designed to investigate the effect of NAFLD on type 2 DM. We conducted a prospective cohort study on 25,232 Korean men without type 2 DM for 5 years. We serially checked the various metabolic factors including fasting glucose and hemoglobin A1c (HbA1c), and monitored the development of type 2 DM. The incidence rate of type 2 DM was compared according to the degree of NAFLD (normal, mild, and moderate to severe), and a Cox proportional hazards model was used to measure the hazard ratios (HRs) of NAFLD on type 2 DM. The incidence rate of type 2 DM increased according to the degree of NAFLD (normal: 7.0%, mild: 9.8%, moderate to severe: 17.8%, P < 0.001). Even after adjusting for other multiple covariates, the HRs (95% confidence interval [CI]) for type 2 DM development was higher in the mild group (1.09; 0.81-1.48) and moderate to severe group (1.73; 1.00-3.01) compared to the normal group, respectively (P for trend <0.001). Conclusion: The development of type 2 DM is potentially more associated with more progressive NAFLD than a normal or milder state. In addition, NAFLD was an independent risk factor for the future development of type 2 DM. These results suggest the potential availability of NAFLD as an early predictor of type 2 DM. (HEPATOLOGY 2013;57:1378–1383)