Hepatic Steatosis and High-Normal Fasting Glucose as Risk Factors for Incident Prediabetes

Area of Science:

• Endocrinology
• Metabolic Syndrome
• Hepatology

Background:

• The role of hepatic steatosis (HS) in the early development of type 2 diabetes is not fully understood.
• Prediabetes is a critical stage preceding type 2 diabetes, necessitating identification of early risk factors.

Purpose of the Study:

• To investigate the impact of HS, quantified by Fatty Liver Index (FLI), and high-normal fasting plasma glucose (FPG) as predictors of incident prediabetes in a nonobese cohort.
• To clarify the independent contribution of these factors, even in individuals without obesity.

Main Methods:

• Retrospective analysis of 1125 nonobese participants with normal glucose metabolism.
• Correlation analysis between FPG and FLI using multiple regression.
• Prospective follow-up of 599 participants with repeated oral glucose tolerance tests to identify prediabetes development.
• Multivariate Cox proportional hazards modeling to assess risk factors for prediabetes.

Main Results:

• A positive correlation was observed between FLI and FPG levels in the entire cohort.
• High-normal FPG (≥ 5.3 mmol/L) was associated with a 2.1-fold increased risk of prediabetes.
• FLI (≥ 16.5) was associated with a 2.2-fold increased risk of prediabetes, independent of insulin resistance markers.

Conclusions:

• Hepatic steatosis, indicated by FLI, and high-normal FPG are independent risk factors for prediabetes in nonobese individuals.
• These findings highlight the importance of monitoring liver health and glucose levels even in the absence of obesity for early diabetes prevention.