Resolution of fatty liver and risk of incident diabetes

CONTEXT: Fatty liver is associated with an increased risk of type 2 diabetes, but whether an increased risk remains in people in whom fatty liver resolves over time is not known.

OBJECTIVE: The objective of the study was to assess the risk of incident diabetes at a 5-year follow-up in people in whom: 1) new fatty liver developed; 2) existing fatty liver resolved, and 3) fatty liver severity worsened over 5 years.

DESIGN AND METHODS: A total of 13,218 people without diabetes at baseline from a Korean occupational cohort were examined at baseline and after 5 years, using a retrospective study design. Fatty liver status was assessed at baseline and follow-up as absent, mild, or moderate/severe using standard ultrasound criteria. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for incident diabetes at follow-up were estimated after controlling for multiple potential confounders.

RESULTS: Two hundred thirty-four people developed incident diabetes. Over 5 years, fatty liver resolved in 828, developed in 1640, and progressed from mild to moderate/severe in 324 people. Resolution of fatty liver was not associated with a risk of incident diabetes [aOR 0.95 (95% CIs 0.46, 1.96), P = .89]. Development of new fatty liver was associated with incident diabetes [aOR 2.49 (95% CI 1.49, 4.14), P < .001]. In individuals in whom severity of fatty liver worsened over 5 years (from mild to moderate/severe), there was a marked increase in the risk of incident diabetes [aOR 6.13 (2.56, 95% CI 14.68) P < .001 (compared with the risk in people with resolution of fatty liver)].

CONCLUSION: Change in fatty liver status over time is associated with markedly variable risks of incident diabetes.

10.1210/jc.2013-1519

0021-972X

3637-3643

Sung, K.C.

be77bd09-0bba-4fcf-8096-c0049ce4e2ce

Wild, S.H.

eb23a87e-b8da-4f3f-8dab-e02e7b5104aa

Byrne, Christopher D.

1370b997-cead-4229-83a7-53301ed2a43c