Fatty liver index is a useful and simple clinical biomarker to identify individuals at risk of developing type 2 diabetes, according to results from the Therapeutic Innovation in Type 2 Diabetes Study (IT-DIAB; ClinicalTrials.gov Identifier: NCT01218061) presented at the 55th Annual Meeting of the European Association for the Study of Diabetes, held September 16 to 20, 2019, in Barcelona, Spain.1
The results were also published in PLOS One.2
There is a growing need for a simple marker that widely screens for nonalcoholic fatty liver disease in patients at metabolic risk. In this study, researchers aimed to determine the clinical usefulness of fatty liver index as a predictor for new-onset diabetes conversion or prediabetes reversion in individuals with prediabetes.
The longitudinal IT-DIAB study included 389 individuals with prediabetes presenting with impaired fasting glucose, defined as fasting plasma glucose (FPG) ≥110 and <126 mg/dL. The primary outcome was the conversion to new-onset diabetes, defined by a first FPG value ≥126 mg/dL, and prediabetes reversion, defined by a first FPG value <110 mg/dL. Multivariate Cox models were used to separately study the associations of both events with baseline fatty liver index.
“After a median follow-up of 3.9 years (range 0.1-6.1), 138 patients (35.5%) converted to [new-onset diabetes],” the researchers noted in their abstract. Fatty liver index was linked to a greater risk for conversion to new-onset diabetes (unadjusted hazard radio [HR] per SD, 1.54; 95% CI, 1.27-1.86; P <.0001), even after adjustment for FPG, hemoglobin A1c, and diabetes risk score (adjusted HR per SD, 1.31; 95% CI, 1.07-1.61; P =.008).
Fatty liver index was also associated with prediabetes reversion (adjusted HR per SD, 0.85; 95% CI, 0.75-0.96; P =.0077). During follow-up, changes in fatty liver index were significantly associated with changes in FPG (P <.0001). The predictive value for new-onset diabetes conversion was not significantly better for the homeostatic model assessment of insulin resistance (HOMA-IR) compared with fatty liver index (area under the receiver operating characteristic curve, 69.3% vs 63.7%; P =.067).
The researchers concluded that fatty liver index is a practical clinical biomarker for use in clinical practice to better risk stratify conversion to new-onset diabetes in patients with prediabetes or potential prediabetes reversion.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
1. Pichelin M, Wargny M, Smati S, et al. Fatty liver index is a strong predictor of changes in glycaemic status in people with prediabetes: the IT-DIAB study. Poster presented at: 55th Annual Meeting of the European Association for the Study of Diabetes (EASD); September 16-20, 2019; Barcelona, Spain. Abstract 175.
2. Wargny M, Smati S, Pichelin M, et al. Fatty liver index is a strong predictor of changes in glycaemic status in people with prediabetes: the IT-DIAB study [published online August 29, 2019]. PLoS One. doi:10.1371/journal.pone.0221524