Fatty Liver Index Identifies Individuals at Risk of Developing Type 2 Diabetes

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.

Follow @EndoAdvisor

Reference

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