Prevalence of undiagnosed diabetes and postchallenge hyperglycaemia in Chinese patients with non-alcoholic fatty liver disease
Article first published online: 20 SEP 2006
Alimentary Pharmacology & Therapeutics
Volume 24, Issue 8, pages 1215–1222, October 2006
How to Cite
WONG, V. W. S., HUI, A. Y., TSANG, S. W. C., CHAN, J. L. Y., WONG, G. L. H., CHAN, A. W. H., SO, W. Y., CHENG, A. Y. S., TONG, P. C. Y., CHAN, F. K. L., SUNG, J. J. Y. and CHAN, H. L. Y. (2006), Prevalence of undiagnosed diabetes and postchallenge hyperglycaemia in Chinese patients with non-alcoholic fatty liver disease. Alimentary Pharmacology & Therapeutics, 24: 1215–1222. doi: 10.1111/j.1365-2036.2006.03112.x
- Issue published online: 20 SEP 2006
- Article first published online: 20 SEP 2006
- Publication data Submitted 19 May 2006 First decision 21 June 2006 Resubmitted 24 June 2006 Resubmitted 3 August 2006 Accepted 7 August 2006
Non-alcoholic fatty liver disease is prevalent in affluent countries and is strongly associated with metabolic syndrome.
To study the prevalence of undiagnosed diabetes and postchallenge hyperglycaemia in Chinese patients with non-alcoholic fatty liver disease.
73 consecutive patients with biopsy-proven non-alcoholic fatty liver disease and no history of diabetes underwent comprehensive metabolic screening. Diagnosis of diabetes and impaired glucose regulation was based on the 2006 American Diabetes Association criteria.
The prevalence of undiagnosed diabetes and impaired glucose tolerance in non-alcoholic fatty liver disease patients was 33% and 29%, respectively. Among patients with 2-h plasma glucose above 7.8 mm, 47% had normal fasting glucose (below 5.6 mm). Impaired glucose tolerance was more common in patients with non-alcoholic steatohepatitis than those with simple hepatic steatosis (P = 0.036), and 2-h plasma glucose correlated with fibrosis stage (Spearman coefficient: 0.25, P = 0.046). In a binary logistic regression analysis, high fasting glucose and low high-density lipoprotein cholesterol were independent factors associated with diabetes. Nevertheless, if oral glucose tolerance test was only performed in non-alcoholic fatty liver disease patients with impaired fasting glucose, 20.8% of diabetes cases would be missed.
Isolated postchallenge hyperglycaemia is common among Chinese non-alcoholic fatty liver disease patients without history of diabetes. It is associated with histological severe disease, and cannot be accurately predicted by any fasting glucose cut-off.