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Fatty liver increases risk for type 2 diabetes
Sung KC. J Clin Endocrinol Metab. 2011;doi:10.1210/jc.2010-2190.
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Individuals with fatty liver are five times more likely to develop type 2 diabetes then those without fatty liver, researchers have found. This increased risk occurred regardless of the patient’s fasting insulin levels, which were used as a marker of insulin resistance in the study.
“Many patients and practitioners view fat in the liver as just ‘fat in the liver,’ but we believe that a diagnosis of fatty liver should raise an alarm for impending type 2 diabetes,” Sun H. Kim, MD, of Stanford University, said in a press release. “Our study shows that fatty liver, as diagnosed by ultrasound, strongly predicts the development of type 2 diabetes regardless of insulin concentration.”
Previous data have demonstrated a relationship between fatty liver and insulin resistance, but the researchers wanted to examine the association between the two in the development of type 2 diabetes. Kim and colleagues examined medical records of more than 11,000 Koreans who had an evaluation that included fasting insulin concentration and abdominal ultrasound, with follow-up 5 years later.
Twenty-seven percent of the individuals examined had fatty liver at baseline. Almost half had baseline insulin concentrations in the highest quartile compared with 17% of those without fatty liver (P<.001).
“Our findings reveal a complex relationship between baseline fatty liver and fasting insulin concentration,” Kim said in the release.
Regardless of baseline insulin concentration, those with fatty liver had significantly more metabolic abnormalities, including higher glucose and triglyceride concentration and lower HDL concentration.
Fatty liver was also associated with a significantly increased risk for incident type 2 diabetes vs. individuals without fatty liver; the researchers calculated a crude OR of 5.05 (95% CI, 2.08-12.29) in the lowest insulin quartile and 6.34 (95% CI, 3.58-11.21) in the highest quartile. Among those in the highest quartile, the OR for developing type 2 diabetes remained significant after multivariate adjustment that included baseline glucose concentration (OR=2.42; 95% CI, 1.23-4.75).
“Our study shows in a large population of relatively healthy individuals that identifying fatty liver by ultrasound predicts the development of type 2 diabetes in 5 years,” Kim said.
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