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Fatty liver progression, resolution linked to incident diabetes

Patients with fatty liver that worsened over time were at greater risk for developing diabetes than those whose fatty liver resolved within the same time period in a recent study.

In a retrospective study conducted in South Korea, researchers evaluated data collected from 13,218 people without diabetes in a Korean occupational cohort at baseline in 2003 and in 2008. Participants underwent physical examinations, blood samples were collected and abdominal ultrasound was performed to determine the presence of fatty liver at both time points. Results were classified as absent, mild or moderate/severe. Patients also responded to questionnaires assessing their tobacco and alcohol use and exercise habits.

Incident diabetes occurred in 234 cases by 2008. During the study, 1,640 patients developed fatty liver, 324 advanced from mild to moderate/severe, and 828 experienced resolution of fatty liver present at baseline. Among those whose fatty liver resolved, 12 cases of incident diabetes occurred.

A significant association was observed between incident diabetes and the development of fatty liver (adjusted OR=2.49; 95% CI, 1.49-4.14), but not between diabetes and resolution of fatty liver (aOR=0.95; 95% CI, 0.46-1.60) after adjustment for factors including age, sex, BMI, alcohol use, exercise and levels of glucose, triglycerides, HDL cholesterol and insulin. Fatty liver progression also was significantly associated with incident diabetes (aOR=7.38; 95% CI, 3.36-16.22), and those who experienced progression were significantly more likely to develop diabetes than patients whose fatty liver resolved during the study (aOR=6.13; 95% CI, 2.56-14.68).

“We have shown that a change in fatty liver status over time (either development of new fatty liver, resolution of existing fatty liver or worsening in severity of existing fatty liver) is associated with markedly variable risks of incident diabetes,” the researchers concluded. “Although the design of this observational study cannot prove causality, these data strongly support the notion that increases or decreases in liver fat influence glucose homeostasis.”

Disclosure: The study was partially supported by Samsung Biomedical.