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Incremental liver fat increases raise diabetes, metabolic syndrome risks

Increases in liver fat correlated with development of cardiovascular disease risk factors including incident diabetes and metabolic syndrome, according to results from a 6-year longitudinal study.

“NAFLD clusters with several cardiometabolic traits including obesity, hypertension, diabetes, and dyslipidemia,” Katherine T. Brunner, MD, from the Boston University School of Medicine in Massachusetts, and colleagues wrote. “However, liver fat is dynamic and changes over time. Even after accounting for increasing BMI over the follow-up period, an adverse progression of liver fat remained significantly associated with incident diabetes and metabolic syndrome.”

Brunner and colleagues enrolled 808 participants from the Framingham Heart Study Third Generation cohort. The participants underwent serial computed tomography scans at baseline and at 6 years.

At follow-up, each standard deviation increase in liver fat correlated with incident impaired fasting glucose (OR = 1.51; 95% CI, 1.22-1.87), incident diabetes (OR = 1.66; 95% CI, 1.25-2.21), and incident metabolic syndrome (OR = 1.76; 95% CI, 1.36-2.26).

After the researchers adjusted for baseline BMI and change in BMI over the 6 years, increasing liver fat remained associated with incident diabetes (OR = 1.68; 95% CI, 1.23-2.3) and metabolic syndrome (OR = 1.55; 95% CI = 1.19-2.03).

“Whereas clinically we often characterize patients as having NAFLD or not, those that have increasing fat over time may be at increased CVD risk,” Brunner and colleagues wrote. “Clinically, weight change or BMI change may not correlate well with changes in liver fat or with changes to an individual’s cardiometabolic risk. Additional studies are needed to determine if tools to quantify liver fat provide additional insights to cardiometabolic risk over changes in BMI.” – by Talitha Bennett

Disclosures: Brunner reports no relevant financial disclosures. Please see the full study for all the other authors’ relevant financial disclosures.